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 |