inforMED
MalfunctionGDY

SITUATE

Received Jul 6, 2026 · Event occurred Jun 8, 2026

Report 3026612481-2026-00040 · MDR key 25728046

Device

Generic name

Gauze/sponge, Internal, X-ray Detectable

Manufacturer

Covidien

Model number

G0404-16P01C-1

Catalog number

G0404-16P01C-1

Lot number

250201AT

Product problems

  • False Negative Result
  • Detachment of Device or Device Component

Patient

Male

  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

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.

Description of Event or Problem

IT WAS REPORTED THAT DURING PROCEDURE, THE RF TAG CAME OUT OF THE RAY TECH AND INTO THE PATIENT. THEY SCANNED THE PATIENT AND IT CAME UP CLEAR WITH THE CHIP BEING IN THE PATIENT. THE CHIP WAS FULLY RETRIEVED WITHOUT THE USE OF AN X-RAY. THERE WAS NO PATIENT HARM/INJURY.