MAUDE Adverse Event Report: Medline Industries, LP Medline; WC,RECL,22",DLA,ELR, 300 LB

Catalog Number	MDS808650
Medical Device Problem Code	Loose or Intermittent Connection (1371)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	08/10/2026
Type of Reportable Event	Malfunction

• Brand Name: Medline
• Common Device Name: WC,RECL,22",DLA,ELR, 300 LB
• Manufacturer (Section D): Medline Industries, LP; three lakes drive; northfield 60093
• Manufacturer Contact: jeffrey johnson ; three lakes drive; northfield 60093
• MDR Report Key: 50935322
• Report Number: 1417592-2026-53484
• Device Sequence Number: 13451682
• Product Code: IOR
• UDI-Device Identifier: 00080196303208
• UDI-Public: 00080196303208
• Combination Product (Y/N): N
• Initial Reporter State: IN
• Initial Reporter Country: US
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Health Professional
• Type of Report: Initial
• Report Date (Section B): 09/29/2026

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: MDS808650
• 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: Not provided
• Initial Report FDA Received Date: 09/29/2026
• 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 Number: 1
• Patient Age: 73 YR
• Patient Sex: Unknown