FDA Adverse Event
Malfunction
Summary report: N
BASIC ORTHO TRAY
MDR report key: 14021412
·
Received April 5, 2022
Report
- Report Number
- MW5108778
- Event Type
- Malfunction
- Date Received
- April 5, 2022
- Date of Event
- April 1, 2022
- Report Date
- April 1, 2022
- Manufacturer
- MEDLINE INDUSTRIES INC. / MEDLINE INDUSTRIES, LP - LAREDO
- Product Code
- OJH
- Product Problem
- Yes
- Report Source
- Voluntary report
- Reporter Location
- PA, US
- Reporter Occupation
- NURSE
- Health Professional
- Yes
Narratives
Description of Event or Problem · 0
LONG BLACK HAIR FOUND IN MEDLINE BASIC ORTHO TRAY FROM THE MANUFACTURER. FDA SAFETY REPORT ID# (B)(4).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1166597 | BASIC ORTHO TRAY | ORTHOPEDIC TRAY | OJH | MEDLINE INDUSTRIES INC. / MEDLINE INDUSTRIES, LP - LAREDO | DYNJ49369 | 22ABB739 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 61 YR | Male |