FDA Adverse Event Other Summary report: N

30432 DERMACEA X-RAY SPG 4X8 12 PLY

MDR report key: 1312141 · Received February 11, 2009

Report

Report Number
1282497-2009-00004
Event Type
Other
Date Received
February 11, 2009
Date of Event
July 1, 2008
Report Date
January 14, 2009
Manufacturer
WINNER INDUSTRIES
Product Code
GDY
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MX
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SUBMITTED 2/11/2009. AN INVESTIGATION IS UNDERWAY; UPON COMPLETION, THE RESULTS WILL FORWARDED.

Description of Event or Problem · 1

IT WAS REPORTED TO COVIDIEN IN 2009 THAT A CUSTOMER HAD A PROBLEM WITH GAUZE SPONGE. THE CUSTOMER REPORTED THAT THE SPONGE IN PACK FRAYED AND LEFT BITS OF THE THREAD IN INCISION/WOUND. SURGEON HAD TO PLUCK BITS FROM INCISION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 30432 DERMACEA X-RAY SPG 4X8 12 PLY X-RAY DETECTABLE SPONGE GDY WINNER INDUSTRIES 441603 UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK