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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: C.R. BARD, INC. (BASD) -3006260740 BROVIAC CV CATHETER, SINGLE-LUMEN, 6.6F; CHRONIC CATHETERS

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C.R. BARD, INC. (BASD) -3006260740 BROVIAC CV CATHETER, SINGLE-LUMEN, 6.6F; CHRONIC CATHETERS Back to Search Results
Catalog Number 0600540
Medical Device Problem Codes Burst Container or Vessel (1074); Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/16/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H10: as the lot number for the device was not provided, a review of the device history records could not be performed.The device has been returned to the manufacturer for evaluation.The investigation of the reported event is currently underway.H11: section a through f ¿ the information provide 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
A patient underwent a chronic catheter placement procedure using the broviac cv catheter approximately six months ago.On (b)(6) 2025, the catheter allegedly broke.Removal, repositioning was done.There was no reported patient injury.
 
Additional Manufacturer Narrative
H11: manufacturing review: a manufacturing review was not requested as the lot number reported is unknown.Investigation summary: one hickman s/l catheter was returned for evaluation.Visual, microscopic, tactile and functional evaluations were performed on the returned device.A c-shape split was noted on the clamping sleeve, proximal to the catheter hub.A complete circumferential break was noted on the distal end of the catheter.The edges of the c-shape split on the clamping sleeve were noted to be uneven.Catheter wear was observed throughout.Therefore, the investigation is confirmed for the identified catheter burst issues as a c-shape split was observed during investigation.However, the reported fracture was unconfirmed as upon investigation burst was identified.A definitive root cause could not be determined based upon the provided information.Labeling review: as the reported event did not allege a labeling or use related issue, a labeling review is not required.G3, h6 (device, method, result, conclusion).Section a through f: the information provide 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
A patient underwent a chronic catheter placement procedure using the broviac cv catheter approximately six months ago.On (b)(6)2025, the catheter allegedly broke.Removal, repositioning was done.There was no reported patient injury.
 
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Brand Name
BROVIAC CV CATHETER, SINGLE-LUMEN, 6.6F
Common Device Name
CHRONIC CATHETERS
Manufacturer (Section D)
C.R. BARD, INC. (BASD) -3006260740
605 north 5600 west
salt lake city 84116
Manufacturer (Section G)
BARD SHANNON LIMITED -3005636544
san geronimo industrial park
lot #1, road #3, km 79.7
humacao PR 00791
Manufacturer Contact
brett curtice
800 w. rio salado pkwy
tempe, AZ 85281
4803032689
MDR Report Key22147390
Report Number3006260740-2025-03653
Device Sequence Number12860485
Product Code LJS
UDI-Device Identifier00801741051821
UDI-Public(01)00801741051821
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K830256
Number of Events Summarized1
Summary Report (Y/N)N
Device Explanted Year2025
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 08/08/2025
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 Number0600540
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer06/03/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/12/2025
Supplement Date Received by Manufacturer08/01/2025
Initial Report FDA Received Date06/05/2025
Supplement Report FDA Received Date08/19/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
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
Patient SexUnknown
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