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Sterile custom surgical procedure packs: (1) 89-10507.02, TOTAL KNEE PACK, Stonewall Jackson H...

FDA Device Recall #Z-1691-2023 - Class II, April 17, 2023

Recall Summary

Recall Number Z-1691-2023
Classification Class II - Moderate risk
Date Initiated April 17, 2023
Status Ongoing
Voluntary Voluntary: Firm initiated

Recalling Firm

Firm DeRoyal Industries Inc
Location Powell, TN
Product Type Devices
Quantity 1,391 cases (2,972 packs)

Product Description

Sterile custom surgical procedure packs: (1) 89-10507.02, TOTAL KNEE PACK, Stonewall Jackson Hospital; (2) 89-10508.02, LOCAL PACK, Stonewall Jackson Hospital; (3) 89-10509.02, LAPAROTOMY PACK, Stonewall Jackson Hospital; (4) 89-10517.04, CNRV BASIC SETUP PACK, New River Valley Medical Center; (5) 89-10526.04, CNRV LAPAROSCOPY PACK, New River Valley Medical Center; (6) 89-10530.04, CNRV PERIPHERAL VAS PACK, New River Valley Medical Center; (7) 89-10532.04, CNRV SPINE PACK, New River Valley Medical Center; (8) 89-10534.02, CMC ANTERIOR SPINE PACK, Carilion Roanoke Memorial Hosp; (9) 89-10544.03, CORONARY BYPASS PACK PGYBK, Carilion Roanoke Memorial Hosp; (10) 89-10545.02, CMC CRANIOTOMY PACK, Carilion Roanoke Memorial Hospital; (11) 89-10552.02, CMC EXTREMITY PACK, Carilion Roanoke Memorial Hospital; (12) 89-10553.02, CMC GYN LAPAROSCOPY PACK, Carilion Roanoke Memorial Hospital; (13) 89-10554.02, CMC GYN MAJOR PACK, Carilion Roanoke Memorial Hospital; (14) 89-10555.02, ORTHO MAJOR PACK, Carilion Roanoke Memorial Hospital; (15) 89-10556.02, CMC HYSTEROSCOPY PACK, Carilion Roanoke Memorial Hospital; (16) 89-10558.04, CCASC LAPAROTOMY PACK, Carilion Roanoke Memorial Hospital; (17) 89-10560.03, CMC LAPAROTOMY PACK, Carilion Roanoke Memorial Hospital; (18) 89-10561.02, CMC LAPAROSCOPY PACK, Carilion Roanoke Memorial Hospital; (19) 89-10562.02, CMC MINOR ENT/PLASTIC PACK, Carilion Roanoke Memorial Hospital; (20) 89-10564.02, CMC MAJOR PLASTIC PACK, Carilion Roanoke Memorial Hospital; (21) 89-10569.02, CMC PEDIATRIC PACK, Carilion Roanoke Memorial Hospital; (22) 89-10570.02, CMC POSTERIOR SPINE PACK, Carilion Roanoke Memorial Hospital; (23) 89-10574.02, CMC SHOULDER ARTHROSCOPY PACK, Carilion Roanoke Memorial Hospital; (24) 89-10575.02, OWEN HIP PACK, Carilion Roanoke Memorial Hosp; (25) 89-10576.03, THORACOSCOPY / THORACOTOMY, Carilion Roanoke Memorial Hosp; (26) 89-10580.03, VALVE REPLACEMENT PACK PGYBK, Carilion Roanoke Memorial Hosp.

Reason for Recall

The custom procedure packs contain light handle covers that have been recalled by another firm.

Distribution Pattern

US Nationwide distribution in the state of VA.

Lot / Code Information

(1) 89-10507.02 - lot 58700464, exp 12/1/2024, GTIN pack-00749756362788, case-50749756362783; (2) 89-10508.02 - lot 58700430, exp 9/1/2026, GTIN pack-00749756362818, case-50749756362813; (3) 89-10509.02 - lot 58775010, exp 12/1/2024, GTIN pack-00749756362832, case-50749756362837; (4) 89-10517.04 - lot 58700579, exp 12/1/2024, GTIN pack-00749756363228, case-50749756363223; (5) 89-10526.04 - lot 58388765, exp 11/1/2024, GTIN pack-00749756363242, case-50749756363247; (6) 89-10530.04 - lot 58543121, exp 11/1/2024, GTIN pack-00749756364447, case-50749756364442; (7) 89-10532.04 - lot 58543905, exp 7/1/2024, GTIN pack-00749756363266, case-50749756363261; (8) 89-10534.02 - lots 58565821 and 58700561, exp 3/1/2024, GTIN pack-00749756363532, case-50749756363537; (9) 89-10544.03 - lot 58700000, exp 10/1/2024, GTIN pack-00749756366342, case-50749756366347; (10) 89-10545.02 - lot 58565830, exp 3/1/2024, GTIN pack-00749756363556, case-50749756363551; (11) 89-10552.02 - lot 58700667, 58700675, and 58724108, exp 12/1/2024, GTIN pack-00749756363549, case-50749756363544; (12) 89-10553.02 - lot 58544060, exp 11/1/2024, GTIN pack-00749756363624, case-50749756363629; (13) 89-10554.02 - lot 58544166, exp 12/1/2024, GTIN pack-00749756363440, case-50749756363445; (14) 89-10555.02 - lot 58589647 and 58724116, exp 12/1/2024, GTIN pack-00749756363648, case-50749756363643; (15) 89-10556.02 - lot 58589567, exp 12/1/2024, GTIN pack-00749756364287, case-50749756364282; (16) 89-10558.04 - lot 58542769, exp 11/1/2024, lot 58621694 and 58699993, exp 12/1/2024, GTIN pack-00749756364430, case-50749756364435; (17) 89-10560.03 - lot 58543201, 58554436, and 58700499, exp 9/1/2024, GTIN pack-00749756363778, case-50749756363773; (18) 89-10561.02 - lot 58542793, exp 11/1/2024, lot 58589591 and 58738016, exp 12/1/2024, GTIN pack-00749756363723, case-50749756363728; (19) 89-10562.02 - lot 58621820, exp 10/1/2024, GTIN pack-00749756364140, case-50749756364145; (20) 89-10564.02 - lot 58543083, exp 11/1/2024, and lot 58700501, exp 12/1/2024, GTIN pack-00749756363761, case-50749756363766; (21) 89-10569.02 - lot 58544182 exp 12/1/2024, GTIN pack-00749756363457, case-50749756363452; (22) 89-10570.02 - lot 58700739, exp 1/1/2024, and 58775036, exp 3/14/2024, GTIN pack-00749756363587, case-50749756363582; (23) 89-10574.02 - lot 58700641, exp 7/1/2024, GTIN pack-00749756364041, case-50749756364046; (24) 89-10575.02 - lot 58565848, exp 12/1/2023, GTIN pack-00749756366144, case-50749756366149; (25) 89-10576.03 - lot 58700704, exp 12/1/2024, GTIN pack-00749756364126, case-50749756364121; (26) 89-10580.03 - lot 58543454, exp 8/1/2024, GTIN pack-00749756366328, case-50749756366323.

Other Recalls from DeRoyal Industries Inc

Recall # Classification Product Date
Z-2305-2026 Class II DeRoyal Industries Inc. Ref 46-406, Covaderm ... May 18, 2026
Z-1291-2025 Class II DeRoyal REF 71-C5100NS Tubing, Suction, Connect... Jan 31, 2025
Z-1174-2025 Class II DeRoyal AMG Suction Connector Tubing REF: 71-2... Jan 15, 2025
Z-0307-2025 Class II DeRoyal CHILDREN'S GENERAL TRACEPACK, REF 89-93... Oct 3, 2024
Z-0308-2025 Class II DeRoyal CHILDREN'S ORTHOPEDIC TRACEPACK, 89-934... Oct 3, 2024

Frequently Asked Questions

Contact your healthcare provider and the device manufacturer immediately. Check whether your specific model number and lot number are included in the recall scope. For external devices, stop using the affected product and arrange a replacement. For implanted devices, do not panic, removal is typically not required unless the risk assessment clearly indicates it. Your physician will guide you based on your individual clinical situation and the FDA's recommended actions. Report any adverse effects you may have experienced to FDA MedWatch at 1-800-FDA-1088.

Class I recalls indicate a reasonable probability of serious adverse health consequences or death from the defect. Class II recalls involve products that may cause temporary or medically reversible adverse health consequences, or where serious consequences are remote. Class III recalls cover products not likely to cause any adverse health consequences, typically involving technical regulatory violations. The classification guides urgency, Class I recalls require immediate action, while Class III may simply involve returning a product or acknowledging a labeling change. Always read the specific recall notice for recommended patient actions.

Report problems with medical devices to the FDA through MedWatch at 1-800-FDA-1088 or online at FDA.gov/safety/medwatch. Healthcare facilities are required by law to report device-related serious injuries and deaths. Patients and consumers can also report voluntarily. Include the device name, manufacturer, model number, and a description of the problem and any patient outcome. Reports from patients and clinicians help the FDA identify emerging safety signals and may trigger investigations that lead to recalls of dangerous devices.

What Should You Do?

Stop using this device if you are affected by this recall. Contact your healthcare provider and the manufacturer immediately for guidance. Report adverse events to FDA MedWatch.

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