MAUDE Adverse Event Report: Medline Industries, LP MEDLINE; CUFF, BP, DIS, 1T, ADL, HP

Catalog Number	MDS9913HP
Medical Device Problem Code	Gas/Air Leak (2946)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	05/21/2025
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that "item leaking when it pumps.".
Additional Manufacturer Narrative
The reported issue was that the medline bp cuff was leaking, and there was no reported death or serious injury associated with this event.Medline received five blood pressure cuffs, visually inspected them for any obvious signs of damage or defects, and tested the cuffs for leakage by using a compatible bulb to inflate each cuff to 300mmhg while observing the gauge for abnormal changes in pressure.No noticeable pressure changes, audible signs of air escaping, or any other signs of leakage occurred, and the complaint issue was not confirmed.The samples are working as intended, and medline was unable to confirm that the product failed to meet specifications.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: CUFF, BP, DIS, 1T, ADL, HP
• 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: 50931506
• Report Number: 1417592-2026-52897
• Device Sequence Number: 9734366
• Product Code: DXQ
• UDI-Device Identifier: 10888277194854
• UDI-Public: 10888277194854
• Combination Product (Y/N): N
• Initial Reporter State: CA
• Initial Reporter Country: US
• PMA/510(K) Number: K161035
• 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): 09/25/2026

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: MDS9913HP
• Device Lot Number: 20231105CKQ
• Was Device Available for Evaluation?: No
• 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: 05/21/2025
• Initial Report FDA Received Date: 09/29/2026
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• 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