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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: C.R. BARD, INC. (COVINGTON) -1018233 BARDEX® LUBRICATH® TEMPERATURE-SENSING FOLEY CATHETER; TEMPERATURE SENSING FOLEY CATHETER

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C.R. BARD, INC. (COVINGTON) -1018233 BARDEX® LUBRICATH® TEMPERATURE-SENSING FOLEY CATHETER; TEMPERATURE SENSING FOLEY CATHETER Back to Search Results
Model Number 119418
Medical Device Problem Code Patient Device Interaction Problem (4001)
Health Effect - Clinical Codes Pain (1994); Appropriate Clinical Signs, Symptoms and Conditions Term/Code Not Available (4581)
Date of Event 04/11/2022
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the customer mentioned about bacteriuria and pain when they were asked of the complications while using the temperature sensing foley catheter.Medical intervention was unknown.
 
Additional Manufacturer Narrative
The investigation is still in progress.Once the investigation is complete a supplemental report will be filed.The device was not returned.
 
Additional 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".The lot number was unknown; therefore, the device history record could not be reviewed.The instructions for use were found adequate and state the following: "visually inspect the product for any imperfections or surface deterioration prior to use.If package is opened or if any imperfection or surface deterioration is observed, do not use.2.Using proper aseptic methods, remove catheter from package.3.Prepare patient per hospital/nursing recommended procedure.4.Proceed with catheterization using standard techniques.5.Inflate the 5cc balloon with a maximum of 10cc sterile water by inserting tip of water-filled luer-tip syringe gently into valve.Do not use a needle.6.Connect catheter to collection container.Connect temperature plug to appropriate patient monitor.7.To deflate the 5cc balloon, gently reinsert the luer tip syringe into the valve and aspirate.8.When temperature monitoring is no longer required, sever cord at valve arm with scissors and cover valve arm containing severed cord with adhesive tape." h11: section a through f - 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 or Problem Description
It was reported that the customer mentioned about bacteriuria and pain when they were asked of the complications while using the temperature sensing foley catheter.Medical intervention was unknown.
 
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Brand Name
BARDEX® LUBRICATH® TEMPERATURE-SENSING FOLEY CATHETER
Common Device Name
TEMPERATURE SENSING FOLEY CATHETER
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
yonic anderson
8195 industrial blvd
covington 30014
7707846100
MDR Report Key14315810
Report Number1018233-2022-03402
Device Sequence Number5223515
Product Code EZC
UDI-Device Identifier00801741076954
UDI-Public(01)00801741076954
Combination Product (Y/N)N
Initial Reporter StateIL
Initial Reporter CountryUS
PMA/510(K) Number
K910846
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Study,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 05/20/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Operator of Device Health Professional
Device Model Number119418
Device Catalogue Number119418
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 04/11/2022
Supplement Date Received by Manufacturer05/09/2022
Initial Report FDA Received Date05/07/2022
Supplement Report FDA Received Date05/31/2022
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Outcome Attributed to Adverse Event Other;
Patient SexUnknown
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