MAUDE Adverse Event Report: C.R. BARD, INC. (COVINGTON) -1018233 PERSONAL CATHETER¿ INTERMITTENT CATHETER

Model Number	63618
Medical Device Problem Code	Improper Chemical Reaction (2952)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	04/05/2023
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that the customer stated a patient was unable to use the intermittent catheter as there was no enough lubricant.I confirm that all four catheters did not have enough lubricant so, could not be used.The patient has used this product for a long time so, is very familiar with it.
Additional Manufacturer Narrative
The investigation is still in progress.Once the investigation is complete a supplemental report will be filed.H11: section a through f - the information provided by bd represents all 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.
Event or Problem Description
It was reported that the customer stated a patient was unable to use the intermittent catheter as there was no enough lubricant.It was confirmed that all four catheters did not have enough lubricant so, could not be used.The patient has used this product for a long time so, was very familiar with it.
Additional Manufacturer Narrative
The reported event was inconclusive because no sample was available for evaluation and further investigation was not conclusive.A potential root cause could be mechanical failure.A review of the device history record did not show any problems or conditions that would have contributed to the reported issue.The instructions for use were found adequate and state the following: "for urological use only.Intended for use by patients for bladder management including urine drainage, collection and measurement.The devices are passed to the urinary bladder via the urethra.Please contact your physician to determine which product options are best for you, paying close attention to product warnings/precautions and adverse reactions.This is a single use device.Do not resterilize.Do not reuse.Reuse of a single use device increases the risk of catheter acquired urinary tract infections.1.Wash your hands thoroughly with soap and water.2.Prior to opening the sealed catheter pouch, apply pressure to the foil packet to release the water.Ensure all water is released from the foil packet.3.Wet the catheter by holding the package with the printed side up and tip the package end-to-end three to six times to wet the catheter.This movement is required so that the water transfers back and forth over the catheter to fully wet the hydrophilic coating.4.Peel open the pack at the funnel/handle end just enough to expose 5 cm (2¿) of the catheter, or for products with an insertion sleeve, expose the insertion sleeve.Don¿t remove the catheter yet.Use the adhesive tab at the funnel end of the pack to stick the pack to a nearby vertical surface while preparing to catheterize.5.Wash the area around the meatus before catheterizing.6.Wash your hands again.7.Using the catheter with insertion sleeve (gripper): a.Hold the insertion sleeve with your dominant hand and squeeze it to grip the catheter shaft as you remove the catheter from the pack.B.Next, hold the catheter funnel above the insertion sleeve with your other hand and slide the insertion sleeve down the shaft, stopping at about 6¿ from the tip.Release the funnel.C.Using the insertion sleeve to hold the catheter firmly, gently pass the tip of the catheter into your urethra until the insertion sleeve nears the meatus.Advance the catheter until urine starts to flow.Without insertion sleeve (gripper): a.Hold the handle/funnel end and remove the catheter from the packaging.B.Gently pass the tip of the catheter into your urethra and advance the catheter until urine starts to flow.8.Try to keep the catheter steady until urine stops flowing.When urine stops flowing, slowly withdraw the catheter, stopping if flow starts again, until the last few drops have drained.9.Finish by disposing of the catheter and its packaging.Wash your hands with soapand water." h11: section a through f - the information provided by bd represents all 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.
Additional Manufacturer Narrative
The reported event was inconclusive because no sample was returned for evaluation.A potential root cause for this failure could be due to "operator error, viscometer failure".It was unknown whether the device had met specifications.Product does not appear to have been used.However, the product is intended to be used for treatment purpose, but it is unknown if there is a relationship between the reported event and the device.The device history record was reviewed and found nothing that could have caused or contributed to the reported event.A labeling review was not performed because labeling could not have prevented the reported failure.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.H3 other text : the device was not returned.
Event or Problem Description
It was reported that the customer stated a patient was unable to use the intermittent catheter as there was no enough lubricant.I confirm that all four catheters did not have enough lubricant so, could not be used.The patient has used this product for a long time so, is very familiar with it.

• Brand Name: PERSONAL CATHETER¿ INTERMITTENT CATHETER
• Common Device Name: INTERMITTENT 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: xeeroy rada ; 8195 industrial blvd; covington 30014 ; 7707846100
• MDR Report Key: 16887478
• Report Number: 1018233-2023-03254
• Device Sequence Number: 6173839
• Product Code: KOD
• UDI-Device Identifier: 00801741069314
• UDI-Public: (01)00801741069314
• Combination Product (Y/N): N
• Initial Reporter Country: EI
• PMA/510(K) Number: K000723
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Other,Company Representative
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 09/05/2023

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: 02/28/2026
• Device Model Number: 63618
• Device Catalogue Number: 63618
• Device Lot Number: JUFP1927
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 04/19/2023
• Supplement Date Received by Manufacturer: 07/05/2023; 09/11/2023
• Initial Report FDA Received Date: 05/08/2023
• Supplement Report FDA Received Date: 07/14/2023; 09/14/2023
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Date Device Manufactured: 04/13/2021
• 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 Number: 1
• Outcome Attributed to Adverse Event: Other
• Patient Sex: Male