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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: C.R. BARD, INC. (COVINGTON) -1018233 LEG BAG

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C.R. BARD, INC. (COVINGTON) -1018233 LEG BAG Back to Search Results
Model Number 150732
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problem Urinary Tract Infection (2120)
Event Date 09/29/2022
Event Type  Injury  
Manufacturer Narrative
The investigation is still in progress.Once the investigation is complete a supplemental report will be filed.The device was not returned.
 
Event Description
It was reported that the patient had two urinary tract infections in two different occasions.Patient went to the doctors and they told it was because the patient did not have enough leg bags.Patient wanted twelve leg bags every ninety days.Patient said they would be asking their doctor to send in new prescription.Per follow up via phone on (b)(6) 2022, it was reported that the patient went to the hospital about urinary tract infection.Stated that patient was on intravenous antibiotics (iv) and oral antibiotics.It was advised by doctor to change their leg bags more frequently, therefore the doctor prescribed more bags for the patient.
 
Manufacturer Narrative
The reported event was inconclusive because no sample was returned.A potential root cause for this failure could be "materials of construction are not biocompatible".It is unknown whether the device had met relevant specifications.The product was used for treatment purposes.It was unknown whether the product had caused the reported failure.The device was not returned for evaluation.The lot number is unknown; therefore, the device history record could not be reviewed.The instructions for use were found adequate and state the following: ¿directions for use: 1.Separate notches within circles.Pull straps through holes and around leg.2.Position bag on leg with flutter valve at top.3.Attach catheter or extension tubing to top inlet.When wearing bag below knee, attach bard extension tubing (catalog no.150615 or 4a4194).4.To empty dispoz-a-bag, push green lever on flip-flo valve out and down.Important: be sure to reclose flip-flo valve after emptying bag.5.After use, this product may be a potential biohazard.Handle and dispose of in accordance with accepted medical practice and applicable, local, state and federal laws and regulations.¿ correction: g 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 device was not returned.
 
Event Description
It was reported that the patient had two urinary tract infections in two different occasions.The patient went to the doctors, and they told it was because the patient did not have enough leg bags.Patient wanted twelve leg bags every ninety days.The patient said they would be asking their doctor to send in a new prescription.Per follow up via phone on 07oct2022, it was reported that the patient went to the hospital about urinary tract infection.Stated that patient was on intravenous antibiotics (iv) and oral antibiotics.It was advised by doctor to change their leg bags more frequently, therefore the doctor prescribed more bags for the patient.
 
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Brand Name
LEG BAG
Type of Device
LEG BAG
Manufacturer (Section D)
C.R. BARD, INC. (COVINGTON) -1018233
8195 industrial blvd
covington 30014
Manufacturer (Section G)
C.R. BARD, INC. (COVINGTON) -1018233
8195 industrial blvd
covington 30014
Manufacturer Contact
xeeroy rada
8195 industrial blvd
covington 30014
7707846100
MDR Report Key15579636
MDR Text Key301551199
Report Number1018233-2022-07745
Device Sequence Number1
Product Code FAQ
UDI-Device Identifier00801741050862
UDI-Public(01)00801741050862
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
EXEMPT
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Consumer
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 02/01/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received10/11/2022
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Lay User/Patient
Device Model Number150732
Device Catalogue Number150732
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received02/01/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient SexMale
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