MAUDE Adverse Event Report: C.R. BARD, INC. (COVINGTON) -1018233 ROCHESTER MEC SPIRIT SHEATH STYLE 2 POP 32MM 30BX

Model Number 37303

Device Problems Loss of or Failure to Bond (1068); Leak/Splash (1354); Nonstandard Device (1420)

Patient Problems Pain (1994); Skin Discoloration (2074); Patient Problem/Medical Problem (2688)

Event Type  malfunction  

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 said the adhesive had ¿gone down,¿ which caused the externals to come off at night.He also said they would come off in the shower, cause pain, make his skin red and blue, and leave adhesive on his skin.Per follow up with the customer on 5feb2020, the adhesive was still stuck on the patient again.It was unknown if he received medical intervention.He tried the 32303 samples and liked them.Per follow up with the customer on 11feb2020, the customer experienced bleeding while using this mec.It was unknown if he received medical intervention.Per follow up with the customer on 14feb2020, the external catheters were leaking due to a lack of adhesive.

Event Description

It was reported that the patient said the adhesive had ¿gone down¿, which caused the externals to come off at night.He also said they would come off in the shower, cause pain, make his skin red and blue, and leave adhesive on his skin.Per follow up with the customer on 5feb2020, the adhesive was still stuck on the patient again.It was unknown if he received medical intervention.He tried the 32303 samples and liked them.Per follow up with the customer on 11feb2020, the customer experienced bleeding while using this mec.It was unknown if he received medical intervention.Per follow up with the customer on 14feb2020, the external catheters were leaking due to a lack of adhesive.

Manufacturer Narrative

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: ¿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 1) wash penis with mild soap and warm water.Dry thoroughly.2) trim pubic hair if necessary.3) open package at perforation.4) to remove plastic insert, squeeze catheter at the top of the white cone and pull to release.5) unroll self-adhering catheter over penis.6) gently squeeze the catheter to properly seal adhesive to the skin.7) 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." h11:section a through f - the information provided by bd 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 bd.

• Brand Name: ROCHESTER MEC SPIRIT SHEATH STYLE 2 POP 32MM 30BX
• Type of Device: MEC
• Manufacturer (Section D): C.R. BARD, INC. (COVINGTON) -1018233; 8195 industrial blvd; covington GA 30014
• MDR Report Key: 9759173
• MDR Text Key: 184332971
• Report Number: 1018233-2020-01385
• Device Sequence Number: 1
• Product Code: NNX
• UDI-Device Identifier: 00801741071195
• UDI-Public: (01)00801741071195
• Combination Product (y/n): N
• PMA/PMN Number: EXEMPT
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: consumer,distributor,other
• Type of Report: Initial,Followup
• Report Date: 03/29/2020

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 02/26/2020
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Lay User/Patient
• Device Model Number: 37303
• Device Catalogue Number: 37303
• Was Device Available for Evaluation?: No
• Date Manufacturer Received: 03/17/2020
• Is This a Reprocessed and Reused Single-Use Device?: No
• Patient Sequence Number: 1