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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Medline Industries, LP MEDLINE; ANEROID,HAND HELD,LRG ADULT

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Medline Industries, LP MEDLINE; ANEROID,HAND HELD,LRG ADULT Back to Search Results
Catalog Number MDS9388
Medical Device Problem Codes Incorrect, Inadequate or Imprecise Result or Readings (1535); Naturally Worn (2988)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/27/2023
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that "worn and not recording appropriately.".
 
Additional Manufacturer Narrative
The reported concern was "worn/readings off," and the item was described as "very worn." 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
ANEROID,HAND HELD,LRG ADULT
Manufacturer (Section D)
Medline Industries, LP
three lakes drive
northfield IL 60093 -275
Manufacturer Contact
arthem smalyukh
three lakes drive
northfield, IL 60093--275
MDR Report Key50856815
Report Number1417592-2026-47960
Device Sequence Number15940966
Product Code DXQ
UDI-Device Identifier10080196177813
UDI-Public10080196177813
Combination Product (Y/N)N
Initial Reporter StateMD
Initial Reporter CountryUS
PMA/510(K) Number
K211084
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Company Representative
Type of Report Initial
Report Date (Section B) 09/22/2026
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 NumberMDS9388
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 11/27/2023
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
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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