PREMIER PRO PLUS 5063

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-05-08 for PREMIER PRO PLUS 5063 manufactured by Svs Llc.

Event Text Entries

[144420049] Clinical area reported that premier pro plus non sterile glove size medium (5063) have fine glitter on them that rubs off when touched. Lot number: ceh-10-06, manufactured: 2018-10. Our system-wide materials management checked multiple boxes w/ this lot # and all had the fine glitter. The following action was taken within our system: based on our current stock, we have estimated that (b)(4) boxes of this lot number have been distributed throughout our hospital system. We identified potentially 79 different locations outside the supply who could have these gloves. Notifications were sent to the other locations for these to be pulled and returned to the main warehouse we provided a limited substitute for this glove with another product and ordered (b)(4) of the premier glove (different lot #) to be delivered.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number8590804
MDR Report Key8590804
Date Received2019-05-08
Date of Report2019-04-09
Date of Event2019-02-27
Report Date2019-04-19
Date Reported to FDA2019-04-19
Date Reported to Mfgr2019-05-08
Date Added to Maude2019-05-08
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePREMIER PRO PLUS
Generic NamePOWDER-FREE NITRILE PATIENT EXAMINATION GLOVE
Product CodeLZA
Date Received2019-05-08
Model Number5063
Lot NumberCEH 10-06
Device Availability*
Device Age1 DA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerSVS LLC
Manufacturer Address14120 BALLANTYNE CORPORATE PL STE 425 CHARLOTTE NC 28277 US 28277


Patients

Patient NumberTreatmentOutcomeDate
10 2019-05-08

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