inforMED
MalfunctionPUI

HALYARD

Received May 21, 2019 · Event occurred Apr 23, 2019

Report 1047429-2019-00010 · MDR key 8627595

Device

Generic name

Drape

Model number

42216NS

Lot number

AC9029081

Product problems

  • Material Integrity Problem
  • Material Integrity Problem

Patient

Not reported

  • No Consequences Or Impact To Patient
  • No Consequences Or Impact To Patient

Narrative

Description of Event or Problem

AVID MEDICAL IS THE MANUFACTURER OF A CUSTOM PROCEDURE TRAY REF: (B)(4), CATARACT PACK THAT INCLUDES THE FOLLOWING COMPONENT: COVER, BACK TABLE 44 X 78, REF: (B)(4) MANUFACTURED BY LA ADA DE ACUNA, S. DE. R. L. DE C. V. (REGISTRATION: (B)(4)). AVID MEDICAL RECEIVED A COMPLAINT ON (B)(6) 2019 ORIGINATED BY (B)(4), OR (B)(4), (B)(6) ALLEGING THAT THE BACK TABLE COVER WAS LEAVING LOOSE FIBERS ON THE STERILE FIELD AND CONSEQUENTLY IN PATIENT'S EYES. THE COVER, BACK TABLE 44 X 78 PART WAS AVAILABLE FOR EVALUATION. AVID MEDICAL ISSUED FORMAL COMPLAINT # (B)(4) TO THE MANUFACTURER PER REF: (B)(4), MANUFACTURER LOT: AC9029081. NO PATIENT INJURY WAS REPORTED.