BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MEDLINE INDUSTRIES, INC.

    MDR report key: 11633767 · Received April 8, 2021

    Report

    Report Number
    11633767
    Event Type
    Malfunction
    Date Received
    April 8, 2021
    Date of Event
    October 26, 2020
    Report Date
    March 23, 2021
    Manufacturer
    MEDLINE INDUSTRIES, INC.
    Product Code
    OJH
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    BACK TABLE PACK OPENED AND FOUND TO HAVE CONCERNS WITH MOLD IN THE FOLDS OF THE PACK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    535368 MEDLINE INDUSTRIES, INC. ORTHOPEDIC TRAY OJH MEDLINE INDUSTRIES, INC. DYNJ04385U 20EKB413

    Patients

    Seq Age Sex Outcome Treatment
    1