FDA Adverse Event Malfunction Summary report: N

ENCORE

MDR report key: 12134062 · Received July 8, 2021

Report

Report Number
12134062
Event Type
Malfunction
Date Received
July 8, 2021
Date of Event
May 7, 2021
Report Date
July 2, 2021
Manufacturer
ANSELL HEALTHCARE PRODUCTS LLC
Product Code
LZA
Product Problem
Yes
Report Source
User Facility report
Reporter Location
CT
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

FIRST WEEK OF (B)(6) SITUATION: NON-INTACT ENCORE LATEX MOISTURIZING STERILE SURGICAL GLOVES ONLY SIZE (LOT 2003432604). BACKGROUND: HOLES WERE FOUND BETWEEN THE THUMB AND INDEX FINGER WHEN DONNING THESE GLOVES FOR STERILE PROCEDURES IN THE EP LAB. THIS OCCURRED WITH 5 PAIRS OF GLOVES TOTAL, 3 PAIRS IN ONE SINGLE DAY. ALL EVENTS OCCUR WHEN STAFF HAD ALREADY DONNED INTACT UNDER GLOVES. HOLES WERE ALWAYS FOUND IMMEDIATELY AND REPLACED WITH INTACT STERILE GLOVES BEFORE ANY DIRECT PATIENT CARE TOOK PLACE. ASSESSMENT: ALL ENCORE LATEX MOISTURIZING STERILE SURGICAL GLOVES ONLY SIZE 7 ½ (LOT 2003432604) WERE REMOVED FROM THE DEPARTMENT. SECOND WEEK OF MAY SITUATION: NON-INTACT ANSELL ENCORE LATEX MOISTURIZING STERILE SURGICAL GLOVES SIZE 7 (NOT 7 ½ AS PRIOR SBAR) (LOT 2003432604 142-65004). BACKGROUND: AGAIN HOLE FOUND BETWEEN THE THUMB AND INDEX FINGER WHEN DONNING THESE GLOVES FOR STERILE PROCEDURE IN THE EP LAB. THIS OCCURRED WITH 1 PAIRS OF GLOVES. HOLE FOUND IMMEDIATELY AND REPLACED WITH INTACT STERILE GLOVES BEFORE ANY DIRECT PATIENT CARE TOOK PLACE. ASSESSMENT: ALL DEPARTMENT STAFF NOTIFIED AND INSTRUCTED TO CAREFULLY CHECK GLOVE INTEGRITY AFTER DONNING. ESPECIALLY THIS SIZE GLOVE AND LOT#. RL SOLUTION PLACED. MANUFACTURER RESPONSE FOR SURGICAL GLOVES, ANSELL GLOVES SIZE 7 AND 7.5 (PER SITE REPORTER): WE PULLED THE LOT #'S AFFECTED. PRODUCT 2018675 WITH LOT 2003432604; PRODUCT 20687280 WITH LOT 2002042905. ANSELL REPLACED AFFECTED PRODUCT AND SENT A CLOSURE LETTER OF THEIR INVESTIGATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1036497 ENCORE POLYMER PATIENT EXAMINATION GLOVE LZA ANSELL HEALTHCARE PRODUCTS LLC 2018675 2003432604

Patients

Seq Age Sex Outcome Treatment
1