KIT: CIRCUMCISION 20/CS
Report
- Report Number
- 1030451-2026-00025
- Event Type
- Injury
- Date Received
- May 18, 2026
- Date of Event
- April 24, 2026
- Report Date
- May 18, 2026
- Manufacturer
- MEDICAL ACTION INDUSTRIES
- Product Code
- OHG
- UDI-DI
- 20809160006020
- PMA / PMN Number
- EXEMPT
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
INCIDENT 9 OF 9. THE PRODUCT INVOLVED IN THE EVENT IS NOT AVAILABLE FOR EVALUATION. A FOLLOW-UP REPORT WILL BE PROVIDED UPON CONCLUSION OF INVESTIGATION. MEDICAL ACTION INDUSTRIES IS THE MANUFACTURER OF THE CIRCUMCISION CONVENIENCE KIT CONTAINING GAUZE 4 X 4 8 PLY COMPONENT, CG-1044-8-4 (LOT 2507JK228A). THE LOT MANUFACTURED IN THE COMPLAINT CONVENIENCE KIT LOT WAS SOURCED FROM SUPPLIER, (B)(4). THIS PRODUCT INCIDENT IS DOCUMENTED IN THE COMPLAINT DATABASE AND IDENTIFIED AS COMPLAINT (B)(4). THIS INFORMATION IS SUBMITTED PURSUANT TO 21CFR803, IN COMPLIANCE WITH THE MEDICAL DEVICE REPORTING REQUIREMENT AND SHOULD NOT BE CONSIDERED TO BE AN ADMISSION THAT PRODUCT IS DEFECTIVE OR HAS CAUSED SERIOUS INJURY.
THE CUSTOMER REPORTED ISSUES WITH THE 4 X 4 COTTON GAUZE CONTAINED WITHIN CIRCUMCISION CONVENIENCE KIT MANUFACTURED BY MEDICAL ACTION INDUSTRIES. DURING APPROXIMATELY NINE CIRCUMCISION CASES, SMALL COTTON FIBERS WERE OBSERVED SHEDDING FROM THE GAUZE, REQUIRING ADDITIONAL TIME TO REMOVE THEM TO PREVENT RETENTION AT THE SURGICAL SITE. NO PATIENT INJURIES WERE REPORTED AS A RESULT OF INCIDENTS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 247371 | KIT: CIRCUMCISION 20/CS | KIT: CIRCUMCISION 20/CS | OHG | MEDICAL ACTION INDUSTRIES | 56779 | 340235 | 20809160006020 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown | Other |