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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: C.R. BARD, INC. (COVINGTON) -1018233 ROCHESTER MEC WIDEBAND L 30BX

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C.R. BARD, INC. (COVINGTON) -1018233 ROCHESTER MEC WIDEBAND L 30BX Back to Search Results
Model Number 36304
Device Problems Difficult to Remove (1528); Sticking (1597)
Patient Problem Tissue Damage (2104)
Event Type  Injury  
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 the sheaths were too sticky and difficult to remove.The patient reported on one occasion to had removed skin off their penis, resulting in an open wound approximately 15 mm x 8 mm, which resolved after 8 days.However, the patient did not seek medical intervention for the wound, but kept it clean.On another occasion, the patient had to cut the sheath off and a portion remained on the penis, as it was unable to be removed until a few days later.
 
Manufacturer Narrative
The reported event was unconfirmed.Received 5 mec lot samples for evaluation.No damages were noted during visual evaluation.Per the functional evaluation, all 5 samples were found within specification.The device history record was reviewed and found nothing that could have caused or contributed to the reported event.The instructions for use state the following: "description/indication the self-adhering male external catheter is designed for the management of male urinary incontinence.Contraindication do not use on irritated or compromised skin.Precaution do not use if allergic reaction occurs.For good hygiene, change catheter daily.Use of a single device for longer periods than 24 hours may increase the risk of complications.Directions: to apply wash penis with mild soap and warm water.Dry thoroughly.Trim pubic hair if necessary.Open package at perforation.To remove plastic insert, squeeze catheter at the top of the white cone and pull to release.Unroll self-adhering catheter over penis.Gently squeeze the catheter to properly seal adhesive to the skin.Connect to collection bag.Important: wear time may be significantly reduced if adhesive is not properly sealed to the skin.Directions: to remove gently roll catheter off the penis.Note: if necessary, apply a warm wet compress (such as a wet washcloth) around the catheter to help loosen the adhesive." (b)(4).
 
Event Description
It was reported that the sheaths were too sticky and difficult to remove.The patient reported on one occasion to had removed skin off their penis, resulting in an open wound approximately 15 mm x 8 mm, which resolved after 8 days.However, the patient did not seek medical intervention for the wound, but kept it clean.On another occasion, the patient had to cut the sheath off and a portion remained on the penis, as it was unable to be removed until a few days later.
 
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Brand Name
ROCHESTER MEC WIDEBAND L 30BX
Type of Device
MEC
Manufacturer (Section D)
C.R. BARD, INC. (COVINGTON) -1018233
8195 industrial blvd
parque industrial aeropuerto
covington GA 30014
Manufacturer (Section G)
C.R. BARD, INC. (COVINGTON) -1018233
8195 industrial blvd
parque industrial aeropuerto
covington GA 30014
Manufacturer Contact
amy gravley
8195 industrial blvd
covington, GA 30014
7707846100
MDR Report Key6758653
MDR Text Key81561407
Report Number1018233-2017-04085
Device Sequence Number1
Product Code NNX
UDI-Device Identifier00801741071089
UDI-Public(01)00801741071089
Combination Product (y/n)N
Reporter Country CodeUK
PMA/PMN Number
EXEMPT
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type health professional,other
Reporter Occupation Patient
Type of Report Initial,Followup
Report Date 02/27/2018
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received08/01/2017
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Lay User/Patient
Device Expiration Date05/31/2021
Device Model Number36304
Device Catalogue Number36304
Device Lot NumberNGAT4366
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer08/07/2017
Is the Reporter a Health Professional? No
Date Manufacturer Received02/26/2018
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured07/17/2016
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) Other;
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