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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: C.R. BARD, INC. (COVINGTON) -1018233 BULB TYPE IRRIGATION SYRINGE 50ML, PLASTIC STERILE; BULB SYRINGE

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C.R. BARD, INC. (COVINGTON) -1018233 BULB TYPE IRRIGATION SYRINGE 50ML, PLASTIC STERILE; BULB SYRINGE Back to Search Results
Catalog Number 0035280
Device Problems Device Contamination with Chemical or Other Material (2944); Appropriate Term/Code Not Available (3191)
Patient Problems No Consequences Or Impact To Patient (2199); No Known Impact Or Consequence To Patient (2692)
Event Date 07/18/2018
Event Type  malfunction  
Manufacturer Narrative
The investigation is still in progress.Once the investigation is complete a supplemental report will be filed.The information provided by bard represents all of 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 bard.
 
Event Description
It was reported that there was black foreign material on the syringe when the user opened the package.It is unknown whether the foreign material is internal or external to the device.
 
Event Description
It was reported that there was black foreign material on the syringe when the user opened the package.It is unknown whether the foreign material is internal or external to the device.
 
Manufacturer Narrative
The reported event was confirmed.Visual evaluation of the returned sample noted one opened, unused bulb irrigation syringe.Visual inspection of the package noted a portion of the material discolored near the tip of the syringe.The discoloration measured approximately 0.0625" in length and appeared to be embedded throughout the material, as if the pvc had been exposed to high temperatures and decomposed.Micro-scale pictures were taken to better observe the nature of the discoloration.The device history record was reviewed and found nothing that could have caused or contributed to the reported event.The instructions for use was found adequate and states the following: ¿irrigation syringe - bulb type, 50cc this is a single use device.Do not re-sterilize any portion of this device.Reuse and/or repackaging may create a risk of patient or user infection, compromise the structural integrity and/or essential material and design characteristics of the device, which may lead to device failure, and/or lead to injury, illness or death of the patient.Contains or presence of phthalates (dehp) contains or presence of phthalates: di(2-ethylhexyl)phthalate (dehp) is a plasticizer used in some polyvinyl chloride medical devices.Dehp has been shown to produce a range of adverse effects in experimental animals, notably liver toxicity and testicular atrophy.Although the toxic and carcinogenic effects of dehp have been well established in experimental animals, the ability of this compound to produce adverse effects in humans is controversial.There is no evidence that neonates, infants, pregnant and breast feeding women exposed to dehp experience any related adverse effects.However, a lack of evidence of causation between dehp-pvc and any disease or adverse effect does not mean that there are no risks single use do not resterilize do not use if package is damaged.Latex-free manufacturer sterilized using ethylene oxide caution, consult accompanying documents authorized representative in the european community after use, this product may be a potential biohazard.Handle and dispose of in accordance with accepted medical practice and applicable laws and regulations.Caution: federal (usa) law restricts this device to sale by or on the order of a physician.¿.
 
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Brand Name
BULB TYPE IRRIGATION SYRINGE 50ML, PLASTIC STERILE
Type of Device
BULB SYRINGE
Manufacturer (Section D)
C.R. BARD, INC. (COVINGTON) -1018233
8195 industrial blvd
covington GA 30014
MDR Report Key7777684
MDR Text Key117014528
Report Number1018233-2018-03532
Device Sequence Number1
Product Code KYZ
UDI-Device Identifier00801741049255
UDI-Public(01)00801741049255
Combination Product (y/n)N
PMA/PMN Number
EXEMPT
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type distributor,other
Type of Report Initial,Followup
Report Date 10/26/2018
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date09/30/2022
Device Catalogue Number0035280
Device Lot NumberNGBW0053
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer08/06/2018
Initial Date Manufacturer Received 07/23/2018
Initial Date FDA Received08/13/2018
Supplement Dates Manufacturer Received10/24/2018
Supplement Dates FDA Received10/28/2018
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
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