|
The reported event was confirmed ¿ cause unknown.The product had caused the reported failure.Based on evaluation finding, observed salt accumulation that causing drainage lumen blockage which can cause flowrate issue.A potential root cause for this failure could be user related (example: over aspirated, incorrect syringe)/collapse lumen/sac close eye/valve damage/salt accumulation.A potential root cause for this failure mode could be wrong duration setting on air purging that cause blocked drainage lumen/drainage eye occlusion.A review of the device history record did not show any problems or conditions that would have contributed to the reported issue.The instructions for use were found adequate and state the following: "[warnings] 1.Method for use (1)do not inflate the balloon in the urethra.[the urethra may be injured.] (2)do not pull the catheter hard.[the bladder/urethra may be injured.] 2.Applicable patients patients with delirium who might pull out catheter [when patient tugs at catheter unconsciously, the bladder and urethra may be damaged.] [contraindications] 1.Method for use: (1) do not reuse.(2) do not resterilize.(3) this device contains 10% povidone-iodine.For patients with past history of allergic hypersensitivity to povidone-iodine or iodine, consider using alternative disinfectants.(4) be careful that the catheter is not exposed to ointments, contrast medium or oil-based lubricants (including vegetable oils such as olive oil,mineral oils such as white petrolatum and animal oils).[they may damage the device and may burst balloon.] (5) do not hold the device with forceps, etc.Avoid contact with any blades or sharp-edged instruments.[catheter damage may cause balloon rupture and accidental balloon removal or failure to deflate or remove the balloon.] 2.Applicable patients (1)patients who are or have been allergic to natural rubberlatex (2)patients with known allergy to silver coated catheter [shape, configuration and principles] bard®i.C.Silver foley tray b consists of a balloon catheter, urine-collecting bag for closed drainage system, syringe prefilled with sterile water, water-soluble lubricant, antiseptic solution, tweezers, waterproof sheet, gauze pads, cotton balls, vinyl glovesand statlock foley.There are several types of closed drainage bags.The bagand statlock foleyincluded in the tray will depend on the product. balloon catheter: natural rubber latex; silver coating2 this product is made with bacti-guard®silver alloy coating. available in sizes 8 to 24 every 2fr 1.Foley catheter shaft 2.Accessories closed drainage bag (the illustrationshows one example of typical configurations.) drainage tube outlet tube clip bard ez-lok sampling port syringe prefilled with sterile water water soluble lubricant antiseptics: bard®10% povidone-iodine solution tweezers gauze pads waterproof sheet cotton balls gloves statlock foley [intended use & effect-efficacy] the device is a tray kit product that is used for the purpose of urinary drainage and combines a disposable catheter designed to be placed in the bladder, and a urine drainage bag.3 [directions for use] 1.Method of use the device is intended for single use only and is not reusable.(1) to secure a sterilefield for the procedure, spread a clean wrapping paper.(2) place waterproof sheet beneath patient¿s buttocks.(fig.1) (3) put on sterile gloves.Open tray and place it on the wrapping paper.(fig.2) fig.1 fig.2 (4) cleanse the area around the external urethral meatus with the cotton balls immersedin the antiseptics.(fig.3) (5) lubricate the distal end of the catheterwith water-soluble lubricant packaged in the tray.(fig.4) fig.3 fig.4 (6) insert catheter into the urethral meatus, and advance it until the balloon enters the bladderand urine flows out through the catheter.Using a syringe packaged in the tray, infuse the specified volume of sterile water into the inflation lumen to inflate the balloon.(fig.5) fig.5 (7) pull catheter to seat the balloon at the level of the bladder neckand secure placement.(8) keep the drainage bag below the bladder level without touching the floor.(fig.6) (9) securedrainagetubeto bed sheet with clip to ensure that there isneither twist nor kink in the tube.(fig.7) 4 fig.6 fig.7 (10) to deflate balloon and remove catheter, inserta luertip(needleless) syringe in the inflation valve to allow the water drain spontaneously.After balloon deflation, withdraw the catheter while confirming that no resistance is encountered. 1) occlude drainage tubing a minimum of 10 cm below the sampling port by kinking the tubing until urine fillsthe tubing up to near (slightly above) the sampling port.2) swab surface of site with antiseptic wipe.3) using aseptictechnique, position theneedle-lesssyringe (slip-tip type or luer-lock type) in the center of the sampling port.The syringe should be held perpendicular to the surface of the sampling port.Press the syringe and twist to lock the syringe onto the sampling port.(fig.8) fig.8 4) aspirate desired volume of urine.After sampling, detach the syringe.Ensure that the rubber stem of the sampling port has returned to its original position.5) unkink tubing. catheter is pre-connected to ez-lok, and the connecting partiscovered with red seal (tamper-evident seal).Remove the seal by grasping the tab at the end of the seal and pullingalong perforations, and then disconnect the catheter and the tubing using aseptic technique.(fig.9) fig.9 2.Precautions for use (1)when resistance is encountered ininserting catheter, stop the procedure and remove the catheter.5 (2)when deflating balloon, do not aspirate with a syringe.[the inflation lumen for balloon deflation may be occluded by negative pressure, and as a result the cathetercannot be removed.] (3)no substance except sterile water should be used to inflate the balloon.[if contrast medium is used, balloon may burst.If normal saline is used, crystallized salt may occlude the inflation lumen to prevent deflation of the balloon.If air is used, airmay escape to cause inadvertent deflation of the balloon so that the catheter may come out prematurely.] (4)do not wipe catheter surface with organic solvents such as alcohol.(5)do not aspirate urine through drainage funnel wall.(6)since movement ofthe body, etc.May twist or bend catheter to cause occlusion, care should be taken to fix the catheter securely.(7)when urinary flow cannot be noted, confirm that the catheter is neither occluded nor broken.(8)avoid force on the connecting parts as they may be accidentally disconnected due to the weight of the drainage bag etc.And may cause urine spill.(9) do not pull or twist the outlet tube.Also, do not squeeze the drainage bag.[the joint of the drainage bag and the outlet tube may be damaged and urine leakage may occur.] (10) when disposing of urine, observe the following; 1)remove the outlet tube from the housing of the urine drainage bag.2)lift the green lever to open with holding the outlet tube.Be careful not to pull the outlet tube when lifting the green lever.3)when disposal of urine is completed, close the green lever and put the outlet tube into the housing.(11)when using statlock foley, observe the following; 1) do not use the statlock device where loss of adherence couldoccur, such as with a confused patient, unattended access device, diaphoretic or nonadherent skin.2) minimize catheter manipulation during statlock stabilization device application and removal.3) do not use thestatlock device for patients showing allergic reaction to tape or adhesive.4) conduct skin assessment prior to application and repeat daily per facility protocol.5) the statlock device should be assessed daily and changed when clinically, indicated, at least every seven days.6) after placing the statlock device, allow to dry completely (10-15 seconds) due to alcohol included in skin protectant.7) use alcohol pads when removal.Do not pull or force pad to remove.[precautions] 1.Precautions for use(exercise caution when using the device in the following patients) (1)exercise caution when using the device in patients with high urinary calcium levels as encrustation on the balloon surface, catheter occlusion or damage may occur.2.Important precautions (1)when catheter is inadvertently removed,inspect the balloon andshaft of catheter for rupture, defect, etc.Before inserting a new catheter.(2)when any part oftheballoon and/or the catheteris missing, consider removing them using a cystoscope.(3)when it is difficult to remove catheter bydeflating the balloon, take appropriate measures according to the section ¿troubleshooting¿.6 when it is difficult to remove catheter by deflating the balloon (expressed as ¿removal-difficult case¿ hereinafter), take appropriate measuresaccording to the following procedures.The following two methods are available for removal-difficult cases.A.Non-rupture method (sterile water is withdrawn without bursting the balloon.) b.Balloon-rupture method with balloon-rupture method, fragments of the ruptured balloon mayremain in the bladder.Therefore, try non-rupture method first.A.Non-rupture method 1)attach luer tip syringe to the inflationvalve.Inject an additional amount of sterile water into the inflation lumen and pump the plunger.2)if situationwouldn't be improved with 1), sever the inflation funnel of valve.(fig.10) fig.10 3)if situation wouldn¿t be improved with 2), sever the catheter shaft while holding it with forceps so that the distal segment may not be drawn into the urethra.(fig.11) fig.11 4)if situation wouldn't be improved with3), insert a needle into the inflation lumen and pump the plunger.(fig.12) fig.12 5)if situation wouldn't be improved with 4), insert a fine steel wire through the inflation lumen of catheter.(fig.13) fig.137 b.Balloon-rupture method 1)inject 100-200ml/cc of saline solution warmed to body temperature into the bladder through the drainage lumen, and then inject a large amount of water or 10-15 ml/cc of mineral oil into the balloon through the inflation lumen with a needle to induce rupture.After rupture of the balloon, irrigate the bladder.(fig.14) mineral oil fig.14 2)if situation wouldn't be improved with 1), attempt following procedures.A)under the radioscopic observation, infuse a contrast medium into the bladder, and burst the balloon by suprapubic puncture of the bladder.(fig.15) fig.15 b)in male patients, burst the balloon by puncture with a needle from the perineal (or suprapubic) region or through the rectumunder ultrasonographic guidance.(fig.16) fig.16 c)in female patients, burst the balloon by insertion of a needle along the urethra.(fig.17) fig.17 3.Malfunction and adverse events8 1) malfunction -catheter kinking, damage, rupture -difficulty or failure to remove the device -occlusion of catheter inner lumens -encrustation -accidental removal of the device due to leakage of sterile water or balloon rupture -device damage due to inappropriate use 2) adverse events -urinary-tract infection -hemorrhage, hematuria -allergy reaction to the device -calculus formation -edema -pain -discomfort -injury of bladder or urethral -urethritis, urinary incontinence -retained balloon fragments [storage method and expiration date] 1.Storage store in a dry, cool place away from heat, moisture, and direct sunlight.2.Expiration date indicated on the direct package and the outer box." correction: d h11: section a through f - the information provided by bd represents all the known information at this time.Despite good faith efforts to obtain additional information, the complainant / reporter was unable or unwilling to provide any further patient, product, or procedural details to bd.H3 other text : the actual/suspected device was inspected.
|
