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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: C.R. BARD, INC. (COVINGTON) -1018233 BARDEX® LUBRI-SIL® I.C. ALL-SILICONE FOLEY CATHETER

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C.R. BARD, INC. (COVINGTON) -1018233 BARDEX® LUBRI-SIL® I.C. ALL-SILICONE FOLEY CATHETER Back to Search Results
Model Number 1758SI16
Device Problems Nonstandard Device (1420); Material Integrity Problem (2978)
Patient Problems No Consequences Or Impact To Patient (2199); No Known Impact Or Consequence To Patient (2692)
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 foley catheter was stiffer than usual, which prevented it from fitting well within the statlock.The complainant alleged that the urine would not drain until the catheter was taken out of the statlock device.
 
Manufacturer Narrative
The device was not returned for evaluation.The device history record was reviewed and found nothing that could have caused or contributed to the reported event.The instructions for use were found adequate and state the following: ¿perform hand hygiene immediately before and after insertion insert urinary catheters using aseptic technique and sterile equipment use the smallest foley catheter possible, consistent with good drainage document the indications for catheter insertion, date and time of catheter insertion, individual who inserted catheter, and date and time of catheter removal in the patient record".
 
Event Description
It was reported that the foley catheter was stiffer than usual, which prevented it from fitting well within the statlock.The complainant alleged that the urine would not drain until the catheter was taken out of the statlock device.
 
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Brand Name
BARDEX® LUBRI-SIL® I.C. ALL-SILICONE FOLEY CATHETER
Type of Device
FOLEY CATHETER
Manufacturer (Section D)
C.R. BARD, INC. (COVINGTON) -1018233
8195 industrial blvd
covington GA 30014
MDR Report Key7980189
MDR Text Key124357661
Report Number1018233-2018-04848
Device Sequence Number1
Product Code EZL
UDI-Device Identifier00801741025228
UDI-Public(01)00801741025228
Combination Product (y/n)N
PMA/PMN Number
K040504
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type other,user facility
Type of Report Initial,Followup
Report Date 11/22/2018
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 Date11/30/2020
Device Model Number1758SI16
Device Catalogue Number1758SI16
Device Lot NumberNGCU1458
Was Device Available for Evaluation? No
Initial Date Manufacturer Received 09/25/2018
Initial Date FDA Received10/18/2018
Supplement Dates Manufacturer Received11/01/2018
Supplement Dates FDA Received11/22/2018
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
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