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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Medline Industries, LP MEDLINE; DBD-MATTRESS,SYSTEM,A20,LAL/ALTERNATING

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Medline Industries, LP MEDLINE; DBD-MATTRESS,SYSTEM,A20,LAL/ALTERNATING Back to Search Results
Catalog Number MDT24A20
Medical Device Problem Code Inadequate Instructions for Non-Healthcare Professional (2956)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/27/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the mattress is leaking.
 
Additional Manufacturer Narrative
The customer stated the mattress is leaking.Medline got the mattress back and confirmed that the wrong product code was used, as this was not the mdt24a10 but the mdt24a20, which is now discontinued and made by a vendor that the division is no longer using.The mattress was manufactured oct 2024 and would not be an out of box quality defect; medline was unable to determine the cause of leakaging cells.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
DBD-MATTRESS,SYSTEM,A20,LAL/ALTERNATING
Manufacturer (Section D)
Medline Industries, LP
three lakes drive
northfield IL 60093 -275
Manufacturer Contact
joseph weiske
three lakes drive
northfield, IL 60093--275
MDR Report Key50946689
Report Number1417592-2026-54312
Device Sequence Number13167837
Product Code FNM
UDI-Device Identifier10080196549733
UDI-Public10080196549733
Combination Product (Y/N)N
Initial Reporter StateGA
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) 09/29/2026
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 NumberMDT24A20
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer02/26/2025
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 01/27/2025
Initial Report FDA Received Date09/30/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
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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