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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: C.R. BARD INC. (COVINGTON) -1018233 BARD® X-FORCE® BALLOON DILATION CATHETER

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C.R. BARD INC. (COVINGTON) -1018233 BARD® X-FORCE® BALLOON DILATION CATHETER Back to Search Results
Catalog Number 997606
Medical Device Problem Code Material Twisted/Bent (2981)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/15/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that before use, after balloon testing, the balloon dilation catheter tip became bent and unusable.Multiple reinsertion attempts were made, but the device could not be used.The surgery was completed using an alternative product.
 
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.
 
Additional Manufacturer Narrative
The reported event was confirmed cause unknown.Visual evaluation of the returned sample noted one opened (without original packaging), used balloon dilation.Visual inspection of the sample noted a slight bend at the tip present.The labeling is found to be adequate.A review of the device history record did not show any problems or conditions that would have contributed to the reported issue.Based on the results of the investigation, no additional actions can be taken at this time.Corrections: d, e, h.Udi format updated with available product information per gudid.H11: sections 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 before use, after balloon testing, the balloon dilation catheter tip became bent and unusable.Multiple reinsertion attempts were made, but the device could not be used.The surgery was completed using an alternative product.
 
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Brand Name
BARD® X-FORCE® BALLOON DILATION CATHETER
Common Device Name
DILATION CATHETER
Manufacturer (Section D)
C.R. BARD INC. (COVINGTON) -1018233
8195 industrial blvd
covington GA 30014
Manufacturer (Section G)
C.R. BARD, INC. (COVINGTON) -1018233
8195 industrial blvd
covington 30014
Manufacturer Contact
xeeroy rada
8195 industrial blvd
covington, GA 30014
7707846100
MDR Report Key21960326
Report Number1018233-2025-03233
Device Sequence Number7151636
Product Code EZN
UDI-Device Identifier00801741052101
UDI-Public(01)00801741052101(11)240903(17)270325(10)BMJVFM18
Combination Product (Y/N)N
Initial Reporter CountryKS
PMA/510(K) Number
K050875
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 01/23/2026
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 Number997606
Device Lot NumberBMJVFM18
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/17/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/17/2025
Supplement Date Received by Manufacturer01/23/2026
Initial Report FDA Received Date05/05/2025
Supplement Report FDA Received Date01/26/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/03/2024
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 Number1
Outcome Attributed to Adverse Event Other;
Patient SexUnknown
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