MAUDE Adverse Event Report: Medline Industries, LP MEDLINE; CANISTER,SUCTION,JUMBO JUG,12L,6EA/C

Catalog Number	OR12L
Medical Device Problem Code	Material Integrity Problem (2978)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	01/29/2025
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that "have had two more come in damaged" and "the tops of the containers are so damaged that we cannot use them"; "only 2 were damaged from the case/6each" and "these were damaged coming out of the box, were not used.".
Additional Manufacturer Narrative
It was reported that they "have had two more come in damaged," the "outside box was not damaged," and "the tops of the containers are so damaged that we cannot use them"; the products "were damaged coming out of the box, were not used." investigation details stated that "this is not a quality issue" and the report "has been filed with osi (operation service issues)," which "takes care of physical shipping damage and/or concealed damage products and they will perform an investigation." a confirmation status was not documented in the investigation details provided; the cause code was updated to "dc:cause traced to transport/storage, osi: shipping damage, medline facility." overall, this was concluded to be physical shipping damage and/or concealed damage handled by osi.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: CANISTER,SUCTION,JUMBO JUG,12L,6EA/C
• Manufacturer (Section D): Medline Industries, LP; three lakes drive; northfield IL 60093 -275
• Manufacturer Contact: venkat gaanuthula ; three lakes drive; northfield, IL 60093--275
• MDR Report Key: 50854290
• Report Number: 1417592-2026-47484
• Device Sequence Number: 21338546
• Product Code: KDQ
• UDI-Device Identifier: 10888277634268
• UDI-Public: 10888277634268
• Combination Product (Y/N): N
• Initial Reporter State: TX
• 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): 09/21/2026

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 Number: OR12L
• Device Lot Number: (10).4260
• 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: 01/29/2025
• Initial Report FDA Received Date: 09/22/2026
• 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
• Usage of Device: Initial
• Patient Sequence Number: 1
• Patient Sex: Unknown