MAUDE Adverse Event Report: Medline Industries, LP MEDLINE; LINER,SEMI-RIGID,1000CC,100EA/CS

Catalog Number	OR510
Medical Device Problem Codes	Difficult to Open or Close (2921); Gas/Air Leak (2946)
Health Effect - Clinical Code	Nail disorder (4897)
Date of Event	02/20/2025
Type of Reportable Event	Malfunction

• Brand Name: MEDLINE
• Common Device Name: LINER,SEMI-RIGID,1000CC,100EA/CS
• Manufacturer (Section D): Medline Industries, LP; three lakes drive; northfield IL 60093 -275
• Manufacturer Contact: joyce qiu ; three lakes drive; northfield, IL 60093--275
• MDR Report Key: 50734075
• Report Number: 1417592-2026-36985
• Device Sequence Number: 18791429
• Product Code: KDQ
• UDI-Device Identifier: 10884389968079
• UDI-Public: 10884389968079
• Combination Product (Y/N): N
• Initial Reporter State: NJ
• Initial Reporter Country: US
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Company Representative
• Type of Report: Initial
• Report Date (Section B): 09/08/2026

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Catalogue Number: OR510
• Device Lot Number: 93024075329C
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: No
• Was the Report Sent to FDA?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 02/20/2025
• Initial Report FDA Received Date: 09/11/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1
• Patient Sex: Unknown