MAUDE Adverse Event Report: C.R. BARD, INC. (COVINGTON) -1018233 BARD® TIEMANN MODEL UROLOGICAL CATHETER COUDE TIP; COUDE FOLEY CATHETER

Catalog Number	010116
Medical Device Problem Code	Material Too Soft/Flexible (4007)
Health Effect - Clinical Code	Urinary Tract Infection (2120)
Date of Event	07/18/2024
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
The investigation is still in progress.Once the investigation is complete a supplemental report will be filed.Udi format updated with available product information per gudid.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 would normally receive a usa product packaged in mexico (lot#nghx0445), but they received a product packaged in malaysia (lot#ngjq1481) that had been defective.The product packaged in mexico (lot#nghx0445) was used over a year and is now dark brown in color while the one from malaysia (lot#ngjq1481) was bright orange.When the catheter was inserted, the catheter folds and bunches up and the issue was ongoing, which resulted in the patient experiencing urinary tract infection.It was unknown what medical intervention was provided for urinary tract infection.Per additional information received 29jul2024, it was reported that the incident of the catheter folding up on itself during insertion happened weeks ago.Patient was addressed with urinary tract infection by doctor and prescribed anti biotics after the urinalysis concluded patient had urinary tract infection.
Additional Manufacturer Narrative
The reported event was inconclusive as no sample was returned for evaluation.It is unknown whether the device had met relevant specifications.The product was used for urological care.It was unknown whether the product had caused the reported failure.A potential root cause for this failure mode could be drainage eyes too large causing weak tip.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: indications for use: for urological use only.Single use.Single patient use.Do not reuse do not use if package is open or damaged.Sterilized using ethylene oxide storage: store catheters at room temperature away from direct exposure to light, preferably in the original box.Caution: this product contains natural rubber latex which may cause allergic reactions.Warnings: ¿ on latex and red rubber catheters, do not use ointments or lubricants having a petroleum base.They will damage latex.¿ visually inspect the product for any imperfections or surface deterioration prior to use.¿ reuse and/or repackaging may create a risk of patient or user infection, compromise the structural integrity and/or essential material and design characteristic of the device, which may lead to failure, and/or to injury, illness or death of the patient.Note: after use, this product may be a potential biohazard.Handle and dispose of in accordance with accepted medical practice and applicable local state and federal laws and regulation.Adverse reactions: urinary tract infection bleeding from urethra irritation of the urethra instruction for intermittent catheters: 1.Wash your hands thoroughly with soap and water.2.Remove catheter from the pack.3.Position yourself comfortably cleaning the opening of the urethra and surrounding area.4.Gently insert rounded end of catheter into urethra.5.When urine stops flowing, remove catheter from urethra.6.Dispose of catheter in accordance with local rules and regulations.7.Wash your hands.Udi format updated with available product information per gudid.Correction: d.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 would normally receive a usa product packaged in mexico (lot#nghx0445), but they received a product packaged in (b)(6) (lot#ngjq1481) that had been defective.The product packaged in mexico (lot#nghx0445) was used over a year and is now dark brown in color while the one from (b)(6) (lot#ngjq1481) was bright orange.When the catheter was inserted, the catheter folds and bunches up and the issue was ongoing, which resulted in the patient experiencing urinary tract infection.It was unknown what medical intervention was provided for urinary tract infection.Per additional information received 29jul2024, it was reported that the incident of the catheter folding up on itself during insertion happened weeks ago.Patient was addressed with urinary tract infection by doctor and prescribed anti biotics after the urinalysis concluded patient had urinary tract infection.

• Brand Name: BARD® TIEMANN MODEL UROLOGICAL CATHETER COUDE TIP
• Common Device Name: COUDE 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: xeeroy rada ; 8195 industrial blvd; covington 30014 ; 7707846100
• MDR Report Key: 19920921
• Report Number: 1018233-2024-04708
• Device Sequence Number: 15498288
• Product Code: KOD
• UDI-Device Identifier: 00801741029875
• UDI-Public: (01)00801741029875(11)240326(17)280630(10)NGJQ1481
• Combination Product (Y/N): N
• Initial Reporter Country: CA
• PMA/510(K) Number: EXEMPT
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Other,Company Representative
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 08/07/2024

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?: Yes
• Operator of Device: Lay User/Patient
• Device Catalogue Number: 010116
• Device Lot Number: NGJQ1481
• 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: 07/18/2024
• Supplement Date Received by Manufacturer: 08/07/2024
• Initial Report FDA Received Date: 08/06/2024
• Supplement Report FDA Received Date: 08/09/2024
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 03/26/2024
• 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: Required Intervention
• Patient Sex: Unknown