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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Medline Industries, LP MEDLINE; TRAY,LACERATION

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Medline Industries, LP MEDLINE; TRAY,LACERATION Back to Search Results
Catalog Number DYNJ03108LF
Medical Device Problem Codes Unsealed Device Packaging (1444); Tear, Rip or Hole in Device Packaging (2385)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/06/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that "protective covering/packaging is prematurely tearing open.".
 
Additional Manufacturer Narrative
The customer reported, "protective covering/packaging is prematurely tearing open" and "physicians refuse to use product as they are worried about sterility." no sample or photo received for our investigation; finished good production records, finished good pack build, and trending were reviewed, and there were no run without approvals, deviations or non-conformance reports that might have had an impact on this issue.With the information provided, medline was unable to confirm the root cause of the issue.There has been no change to the reportability decision associated with this complaint.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.
 
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Brand Name
MEDLINE
Common Device Name
TRAY,LACERATION
Manufacturer (Section D)
Medline Industries, LP
three lakes drive
northfield IL 60093 -275
Manufacturer Contact
zelek alexander
three lakes drive
northfield, IL 60093--275
MDR Report Key50853707
Report Number1417592-2026-47378
Device Sequence Number9953991
Product Code MCY
UDI-Device Identifier10080196841202
UDI-Public10080196841202
Combination Product (Y/N)N
Initial Reporter StateID
Initial Reporter CountryUS
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Company Representative
Type of Report Initial
Report Date (Section B) 09/21/2026
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 NumberDYNJ03108LF
Device Lot Number24KBI327
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 03/06/2025
Initial Report FDA Received Date09/22/2026
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
Patient Sequence Number1
Patient SexUnknown
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