MAUDE Adverse Event Report: MEX03 MEXICO-JUAREZ PRESOURCE CHI STD SPECIAL PROCEDURE 6 702; GENERAL SURGERY TRAY (KIT)

Model Number	CHIP99IR6C
Health Effect - Clinical Code	No Known Impact Or Consequence To Patient (2692)
Date of Event	01/01/1980
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
The device history record review did not indicate any exception that would have led to the reported incident.The supplier checked on retained sample.The average linting data was 0.150g/ 10 pieces and within normal limits (=0.38g/10 pieces).No sample was provided for investigation at this time, only photo of linting on the glove was provided.According to our supplier, the or towel is made of cotton, so lint is born and inevitable.Our supplier is continuously working with cardinal health to better control the linting and have implemented several measures to improve it: a.Suctions machines have been installed in grey cloth rolling process, dyeing process and cutting process b.The suction process was added before product's final folding and workers do it according to standard operation procedure requirement.C.Linting test method and acceptable criteria was stipulated to see the suction results.(=0.38g/10 pieces).D.In the folding process, the supplier used one cloth pad under 100 pieces semi-finished products to avoid linting stuck onto the products during product's transfer.Based on the investigation, all linting test data was within the acceptable range.There was no abnormal situation that had happened in production.Therefore, the root cause could not be determined and no further action taken.The complaint information was shared with the relevant sectors within the manufacturing facility for their awareness and we will continue to monitor for this type of incident.
Event or Problem Description
The customer says the blue towels are producing more lint than before.Doctor says it's getting caught up on stents and wires.

• Brand Name: CHI STD SPECIAL PROCEDURE 6 702
• Common Device Name: GENERAL SURGERY TRAY (KIT)
• Manufacturer (Section D): MEX03 MEXICO-JUAREZ PRESOURCE; c. arcadia 1580 , col. terraza; cd.juarez , chihuahua CP 32 599; MX CP 32599
• MDR Report Key: 9107560
• Report Number: 1423537-2019-00347
• Device Sequence Number: 2447985
• Product Code: LRO
• UDI-Device Identifier: 10885380095795
• UDI-Public: 10885380095795
• Combination Product (Y/N): N
• Initial Reporter State: KY
• Initial Reporter Country: US
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: health professional
• Initial Reporter Occupation: Other
• Type of Report: Initial
• Report Date (Section B): 09/23/2019

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
• Operator of Device: Health Professional
• Device Model Number: CHIP99IR6C
• Device Catalogue Number: CHIP99IR6C
• Device Lot Number: 263654
• Was Device Available for Evaluation?: Yes
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: 08/29/2019
• Initial Report FDA Received Date: 09/23/2019
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Required Intervention