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U.S. Department of Health and Human Services

Class 2 Device Recall General Plastic Pack

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  Class 2 Device Recall General Plastic Pack see related information
Date Initiated by Firm April 22, 2015
Create Date October 20, 2016
Recall Status1 Terminated 3 on October 25, 2016
Recall Number Z-0196-2017
Recall Event ID 71968
Product Classification Light, surgical, ceiling mounted - Product Code FSY
Product General Plastic Pack, Kit number PSS2432, PSS2432(A, PSS2717, PSS2717(A, and PSS2717(B.
convenience custom kits used for general surgery in hospital operating room

Code Information Lot Numbers/Expiration Dates:  66206 2/25/2015 61424 8/18/2015 63370 11/2/2015 58543 11/8/2015 65418 11/9/2015 63596 11/11/2015 61749 11/22/2015 63420 1/4/2016 64414 1/9/2016 64968 1/13/2016 56888 5/22/2016 56889 5/23/2016 57341 6/8/2016 68248 7/11/2016 58351 7/14/2016 67619 7/16/2016 67417 8/9/2016 57586 8/14/2016 70741 9/5/2016 70742 9/5/2016 68659 9/21/2016 69502 9/23/2016 70631 9/24/2016 69732 9/26/2016 69073 9/27/2016 68295 9/28/2016 68059 9/29/2016 70630 10/23/2016 71024 12/10/2016 71126 12/17/2016 72093 1/7/2017 70999 1/18/2017 73785 1/27/2017 73806 4/5/2017 73807 4/9/2017 74111 4/10/2017 73618 4/20/2017 76130 7/15/2017 81087 1/9/2018   
Recalling Firm/
Manufacturer
Windstone Medical Packaging, Inc.
1602 4th Ave N
Billings MT 59101-1521
For Additional Information Contact Vicki Davis
406-259-6387
Manufacturer Reason
for Recall
The Medtronic COVER LIGHT HANDLE DISPOSABLE GLOVES, Part # 13140, of the custom AMS kit were recalled because gloves may contain splits or holes compromising sterility.
FDA Determined
Cause 2
Unknown/Undetermined by firm
Action Aligned Medical Solutions (AMS) sent the Medtronic Urgent Medical Device for Devon Light Glove letter, dated April 23, 2015 to all affected consignees. Consignees were informed that the sterile kits assembled and distributed by AMS contain the recalled Devon COVER LIGHT HANDLE DISPOSABLE Glove (AMS part #13140 or Medtronic part # 571711) due to splits or holes. Consignees were advised to identify any remaining affected kits and follow the over-labeling instruction. At the time the kit is opened for use, any light gloves should be identified and disposed of pursuant to the medical waste policies in effect at your institution. AMS can provide replacement product if needed or you can contact your local Medtronic sales rep for sterile replacements as well. Due to the manufacturing process and finished sterilized packs in inventory, or at your facility, over labeling of inventory and/or future shipment affected by this recall will be labeled with a sticker attached to each pack. This sticker will read: RECALL NOTICE Medtronic announced the recall l of Devon Light Glove contained in this kit after it was sealed and sterilized. All other components in the kit are not affected by this recall. 1. At the time the kit is opened for use any Light Glove manufactured by Medtronic should be identified and set aside 2. The recalled light glove should be rendered unusable to protect against inadvertent use and disposed of pursuant to the medical waste policies in effect at your institution. Consignees should complete the attached Reply Form and fax to AMS at 406-256-9875. For any questions about this recall, please call 321-527-7714. For questions regarding this recall call 404-259-6387.
Quantity in Commerce 1378 kits
Distribution Nationwide Distribution to California, Florida, Georgia, Illinois, Kansas, Louisiana, Michigan, New Jersey, Nevada, Texas, Virginia, and Wyoming.
Total Product Life Cycle TPLC Device Report

1 A record in this database is created when a firm initiates a correction or removal action. The record is updated if the FDA identifies a violation and classifies the action as a recall, and it is updated for a final time when the recall is terminated. Learn more about medical device recalls.
2 Per FDA policy, recall cause determinations are subject to modification up to the point of termination of the recall.
3 For details about termination of a recall see Code of Federal Regulations (CFR) Title 21 §7.55.
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