MAUDE Adverse Event Report: Medline Industries, LP MEDLINE; LIFT,PAT,HYDRAULIC,6 POINT CRD,NO SLING

Catalog Number	MDS88200HL
Medical Device Problem Code	Fracture (1260)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	08/18/2023
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that "we put the item together brand new out of the box & the bearing balls from the rear wheel swivel part connected to frame started falling out & making the wheel wobble & unable to roll correctly.".
Additional Manufacturer Narrative
The customer stated "we put the item together brand new out of the box & the bearing balls from the rear wheel swivel part connected to frame started falling out & making the wheel wobble & unable to roll correctly." the customer provided a photo of the product sticker and a video of the caster, but not of the full unit; a physical sample was not provided, and only a visual review of the defect could be conducted.The investigation results were confirmed, and after reviewing the video it was discovered that the bearing on one of the locking casters for the base has fractured and the bearing balls have fallen out.Based on complaint details the product is in new condition, therefore this issue is most likely due to shipping damage; no product changes were identified that could've contributed to this product failure, and the division will monitor through trending.There were no reports of death, serious injury, medical intervention, or follow up care.It has been determined that the reported event could cause or contribute to serious injury if it were to occur again.In an abundance of caution, this is a reportable event.If additional information becomes available this report will be reopened and reevaluated.This medical device report (mdr) is being submitted as part of retrospective review activities, which include review of historical data in accordance with regulations at 21 cfr part 803.The information included in this mdr reflects the information reasonably known to the manufacturer at the time of this retrospective review and submission.

• Brand Name: MEDLINE
• Common Device Name: LIFT,PAT,HYDRAULIC,6 POINT CRD,NO SLING
• Manufacturer (Section D): Medline Industries, LP; three lakes drive; northfield IL 60093 -275
• Manufacturer Contact: haroon mian ; three lakes drive; northfield, IL 60093--275
• MDR Report Key: 50789482
• Report Number: 1417592-2026-42236
• Device Sequence Number: 9570002
• Product Code: FSA
• UDI-Device Identifier: 40884389144825
• UDI-Public: 40884389144825
• Combination Product (Y/N): N
• Initial Reporter State: MS
• 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): 09/15/2026

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: MDS88200HL
• 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: 08/18/2023
• Initial Report FDA Received Date: 09/16/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• Is the Device Labeled for Single Use? (Y/N): No
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Patient Sex: Unknown