FDA Adverse Event Malfunction Summary report: N

MEDICAL ACTION INDUSTIRES

MDR report key: 6591594 · Received May 25, 2017

Report

Report Number
9616874-2017-00001
Event Type
Malfunction
Date Received
May 25, 2017
Date of Event
November 30, 2016
Report Date
January 9, 2017
Manufacturer
JIANGSU PROVINCE JIANERKANG MEDICAL DRESSING CO.,L
Product Code
GDY
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
RISK MANAGER

Narratives

Additional Manufacturer Narrative · 1

THE LAP SPONGE RING OR BLUE LOOP ARE USED FOR HELPING DOCTOR TO PULL THE LAP SPONGE OUTSIDE FROM THE ABDOMEN AFTER OPERATION. AFTER OPERATION, THE PATIENT WILL BE TREATED WITH X-RAY SCAN TO CHECK IF ANY FOREIGN COMPONENT LIKE RING OR BLUE LOOP ETC. LEFT INSIDE THE PATIENT'S BODY. LAP SPONGE RING CONTAINS BARIUM SULFATE, AND IT CAN BE VISIBLE UNDER X-RAY, SO EVEN THIS RING LEFT INSIDE THE PATIENT'S BODY, IT CAN BE DETECTED UNDER X-RAY, SO THIS PROBLEM DID NOT RESULT IN SERIOUS INJURY OR DEATH. SO NEED NOT REMEDIAL ACTION FOR THIS PROBLEM.

Description of Event or Problem · 1

LAP SPONGE RING DETACHED FROM SPONGE AND WAS DISCOVERED MISSING DURING OB PROCEDURE OR COUNT. THE RING WAS LOCATED IN THE PATIENT'S ABDOMEN AND SUCCESSFULLY RETRIEVED PRIOR TO PROCEDURE CONCLUSION WITH NO ADVERSE SIDE EFFECTS ASSOCIATED. THE COMPLAINT LAP SPONGES WERE MEDICAL ACTION INDUSTRIES BRANDED;

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
373897 MEDICAL ACTION INDUSTIRES LAP SPONGE 18??18 W/XR RING 200/CS GDY JIANGSU PROVINCE JIANERKANG MEDICAL DRESSING CO.,L 402 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention