MAUDE Adverse Event Report: C.R. BARD, INC. (COVINGTON) -1018233 BARD TOUCHLESS URETHRAL CATHETER KIT WITH RED RUBBER CATHETER

Model Number	4A3053
Medical Device Problem Code	Component Missing (2306)
Health Effect - Clinical Codes	No Patient Involvement (2645); No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	11/16/2020
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
The investigation is still in progress.Once the investigation is complete a supplemental report will be filed.
Event or Problem Description
It was reported that jelly or iodine's was missing from 12 bard touchless catheter in the last couple of months.
Additional Manufacturer Narrative
The reported event was inconclusive since sample condition was poor.It is unknown whether the device had met relevant specifications.The product was used for treatment.It was unknown whether the product had caused the reported failure.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: "instructions for use preparing for procedure: ¿ open kit and remove contents.¿ remove top of calibrated plastic bag as directed and open tube of lubricant.¿ by squeezing rigid collar, open neck of bag to form round shape.¿ empty tube of lubricant into top chamber of bag so that lubricant is deposited at bottom of chamber.(caution: care should be taken not to contaminate edges or inside of bag with fingers or tube.) ¿ open package of povidone-iodine swabs as directed.¿ prep urethral meatus and the area surrounding the meatus with swabs.¿ while squeezing rigid collar bring top chamber of bag over head of penis.¿ meatus should be pressed tight against rigid catheter guide.To feed catheter into urethra ¿ if user is predominately left-handed reverse hands suggested below.¿ stabilize penis with top chamber of bag between index and second finger of left hand.Place thumb and ring finger on opposite sides of rigid catheter guide recess to stabilize catheter.¿ with right hand grasp catheter through bag approximately 1¿ below rigid catheter guide and push catheter toward meatus.¿ stabilize catheter with thumb and ring finger through catheter guide recess and return right hand to position approximately 1¿ away.¿ repeat motions until catheter reaches bladder and urine starts to flow.(if some resistance is felt while moving catheter through urethra, change position of urethra with slight up or down movement of left hand while holding penis firmly within top chamber.)".
Event or Problem Description
It was reported that iodine was missing in the bard touchless catheter kit for the last couple of months.Customer was using bard touchless for 18 years and this had been happened quite a few times but never reported it.

• Brand Name: BARD TOUCHLESS URETHRAL CATHETER KIT WITH RED RUBBER CATHETER
• Common Device Name: RED RUBBER CATHETER
• Manufacturer (Section D): C.R. BARD, INC. (COVINGTON) -1018233; 8195 industrial blvd; covington 30014
• MDR Report Key: 10978028
• Report Number: 1018233-2020-21555
• Device Sequence Number: 16725161
• Product Code: FCM
• UDI-Device Identifier: 00801741030680
• UDI-Public: (01)00801741030680
• Combination Product (Y/N): N
• Initial Reporter State: IL
• Initial Reporter Country: US
• PMA/510(K) Number: K910653
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: consumer,other
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 05/09/2021

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
• Operator of Device: Lay User/Patient
• Device Expiration Date: 11/30/2021
• Device Model Number: 4A3053
• Device Catalogue Number: 4A3053
• Device Lot Number: NGDQ0565
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 11/16/2020
• Initial Date Received by Manufacturer: 11/16/2020
• Supplement Date Received by Manufacturer: 05/09/2021
• Initial Report FDA Received Date: 12/09/2020
• Supplement Report FDA Received Date: 06/01/2021
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Other