MAUDE Adverse Event Report: C.R. BARD, INC. (COVINGTON) -1018233 NICORE NITINOL GUIDEWIRE

Catalog Number	150NFA38
Medical Device Problem Code	Difficult to Insert (1316)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	08/11/2023
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.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.H3 other text : the device was not returned.
Event or Problem Description
It was reported that the survey respondent stated no when they asked the guidewire was successful in providing transurethral/percutaneous access into the bladder/ureter/renal pelvis.Physician stated the guidewire was not successful in providing transurethral/percutaneous access into the bladder/ureter/renal pelvis because oops, they actually were in relation to 150nfa38 nicore¿ nitinol/nitinol guidewire,.038 in., 3cm, 150cm, standard, angled.Per additional information received via email on 23aug2023, it was reported that the survey respondent stated that no, the guidewire was not successful in providing transurethral access into the ureter because oops, they actually were in relation to 150nfa38 nicore¿ nitinol/nitinol guidewire,.038 in., 3cm, 150cm, standard, angled.
Event or Problem Description
Critical care nurses reported that no when they asked the guidewire was successful in providing transurethral/percutaneous access into the bladder/ureter/renal pelvis.Physician stated the guidewire was not successful in providing transurethral/percutaneous access into the bladder/ureter/renal pelvis because oops, they actually were in relation to 150nfa38 nicore¿ nitinol/nitinol guidewire,.038 in., 3cm, 150cm, standard, angled.Per additional information received via email on 23aug2023, critical care nurses reported in an online survey that no, the guidewire was not successful in providing transurethral access into the ureter because oops, they actually were in relation to 150nfa38 nicore¿ nitinol/nitinol guidewire,.038 in., 3cm, 150cm, standard, angled.
Additional Manufacturer Narrative
The reported event is inconclusive as no sample was returned for evaluation.Although an exact root cause could not be determined a potential root cause could be guidewire length too short.A dhr review is not required as no lot number was reported.The instructions for use were found adequate and state the following: "warning: inspect all guidewires for damage prior to use.Bending or kinking during or prior to placement could damage the guidewire.Do not attempt to use the guidewire if it has been damaged.Use of a damaged wire may result in damage to the urinary tract.Do not reshape the guidewire by any means.Attempting to reshape the guidewire may cause damage resulting in release of fragments into the urinary tract.Failure to exercise proper caution may result in damage to the urinary tract.Do not advance or withdraw a guidewire when resistance is encountered as perforation could occur.Do not manipulate or remove the guidewire through a metal cannula or needle.This may result in destruction/separation of the outer jacket of the wire requiring retrieval." 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.H3 other text: the device was not returned.

• Brand Name: NICORE NITINOL GUIDEWIRE
• Common Device Name: NITINOL GUIDEWIRE
• 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: 17661430
• Report Number: 1018233-2023-06464
• Device Sequence Number: 15234769
• Product Code: EZB
• UDI-Device Identifier: 00801741051470
• UDI-Public: (01)00801741051470
• Combination Product (Y/N): N
• Initial Reporter State: PA
• Initial Reporter Country: US
• PMA/510(K) Number: EXEMPT
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Other,Study
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup
• Report Date (Section B): 12/27/2023

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: Health Professional
• Device Catalogue Number: 150NFA38
• 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: 08/11/2023
• Supplement Date Received by Manufacturer: 12/27/2023
• Initial Report FDA Received Date: 08/31/2023
• Supplement Report FDA Received Date: 12/28/2023
• 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 Number: 1
• Outcome Attributed to Adverse Event: Other
• Patient Sex: Unknown