MAUDE Adverse Event Report: Medline Industries, LP MEDLINE; PORTABLE DVT PUMP/SLEEVE,CORDLESS,10PR

Catalog Number	MDS600GO
Medical Device Problem Code	Electrical /Electronic Property Problem (1198)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	07/10/2025
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that this is throwing a code and not wokring.
Additional Manufacturer Narrative
The customer reported the item was throwing a code and not working.Physical samples of the complaint issue were provided by the customer for review; based off the images, one pair was received in used condition, and both sleeves were provided along with the charging cord.Based on the information provided and the results of the investigation, the reported issue was not confirmed and the product was not confirmed to have failed to meet specifications.The cause was documented as not confirmed with received sample, and the review indicated no need for further action at this time.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: PORTABLE DVT PUMP/SLEEVE,CORDLESS,10PR
• Manufacturer (Section D): Medline Industries, LP; three lakes drive; northfield IL 60093 -275
• Manufacturer Contact: konstantina callas ; three lakes drive; northfield, IL 60093--275
• MDR Report Key: 50947970
• Report Number: 1417592-2026-54530
• Device Sequence Number: 18547684
• Product Code: JOW
• UDI-Device Identifier: 10197344098415
• UDI-Public: 10197344098415
• Combination Product (Y/N): N
• Initial Reporter State: MO
• Initial Reporter Country: US
• PMA/510(K) Number: K200568
• 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): 09/29/2026

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: MDS600GO
• Device Lot Number: MH240702001
• Was Device Available for Evaluation?: Yes
• Date Returned to Manufacturer: 07/29/2025
• 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: 07/10/2025
• Initial Report FDA Received Date: 09/30/2026
• 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