FDA Adverse Event Malfunction Summary report: N

ACS

MDR report key: 8159344 · Received December 13, 2018

Report

Report Number
8159344
Event Type
Malfunction
Date Received
December 13, 2018
Date of Event
May 20, 2018
Report Date
November 28, 2018
Manufacturer
AMERICAN CONTRACT SYSTEMS, INC.
Product Code
LRO
Product Problem
Yes
Report Source
User Facility report
Reporter Location
VA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

SURGICAL SAFETY ISSUE - STERILE SUPPLY PACK CONTAINED 9 RADIOPAQUE SPONGES INSTEAD OF THE NATIONAL STANDARD OF MULTIPLES OF 10. PER AORN STANDARDS, THE 9 WERE PASSED OFF THE STERILE FIELD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1001362 ACS GENERAL SURGERY TRAY LRO AMERICAN CONTRACT SYSTEMS, INC. CDME17C 782181

Patients

Seq Age Sex Outcome Treatment
1