inforMED
MalfunctionGDY

SITUATE

Received Nov 10, 2025 · Event occurred Sep 19, 2025

Report 3026612481-2025-00019 · MDR key 23510341

Device

Generic name

Gauze/sponge, Internal, X-ray Detectable

Manufacturer

Covidien

Model number

G0404-16P01CN-1

Catalog number

G0404-16P01CN-1

Lot number

25808AT

Product problems

  • Material Fragmentation
  • Material Fragmentation

Patient

NA · Unknown

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Description of Event or Problem

ACCORDING TO THE REPORTER, DURING USE, THE FOUR GAUZES WERE FALLING APART WHEN SATURATED WITH BLOOD, HEMOGLOBIN. THERE WAS NO PATIENT INJURY.

Additional Manufacturer Narrative

D10 CONCOMITANT PRODUCT: G0404-16P01CN-1, GAUZE; XRAY; RFD; 4X4; 16-PLY; NSTRL; LF (LOT#25808AT); G0404-16P01CN-1, GAUZE; XRAY; RFD; 4X4; 16-PLY; NSTRL; LF (LOT#25808AT); G0404-16P01CN-1, GAUZE; XRAY; RFD; 4X4; 16-PLY; NSTRL; LF (LOT#25808AT) MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.