FDA Adverse Event Summary report: N

*

MDR report key: 3820074 · Received April 24, 2014

Report

Report Number
3820074
Date Received
April 24, 2014
Date of Event
February 6, 2014
Report Date
April 24, 2014
Manufacturer
COVIDIEN
Product Code
GDY
Report Source
User Facility report
Reporter Location
AL, US
Reporter Occupation
RISK MANAGER

Narratives

Description of Event or Problem · 1

ONLY 8 RAY-TEC SPONGES WERE IN THE CUSTOM PACK. THERE SHOULD HAVE BEEN 10. PACKAGES OF SPONGES THAT DO NOT HAVE THE CORRECT NUMBER CREATE THE RISK OF INCORRECT COUNT OR A RETAINED SURGICAL ITEM. THE PACK WAS REMOVED FROM THE FIELD AND FROM THE ROOM. SPONGES AND PACK INFORMATION FORWARD TO MATERIALS MANAGEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
249544 * SURGICAL SPONGES GDY COVIDIEN LSRHHMAJBAA 684131

Patients

Seq Age Sex Outcome Treatment
1 51 YR