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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: C.R. BARD INC. (COVINGTON) -1018233 BARDEX® LUBRICATH® HEMATURIA FOLEY CATHETER

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C.R. BARD INC. (COVINGTON) -1018233 BARDEX® LUBRICATH® HEMATURIA FOLEY CATHETER Back to Search Results
Catalog Number 2551H20
Medical Device Problem Code Material Fragmentation (1261)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/30/2025
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.This report references a us equivalent device.The us udi equivalent for this product number is used.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 foley catheter had broken causing urine leakage.
 
Event or Problem Description
It was reported that foley catheter had broken causing urine leakage.
 
Additional Manufacturer Narrative
The reported event was confirmed - cause unknown.The product had caused the reported failure.Based on the attached photos, it was observed the catheter was torn between the junction of the drainage funnel and the irrigation funnel.A potential root cause for this failure mode could be funnel slurry dipping level below bifurcation that can lead to customer complaint weak inflation arm.A review of the device labelling has been conducted for investigation purposes and was found adequate.A review of the device history record did not show any problems or conditions that would have contributed to the reported issue.Therefore, no additional action is required at this time.Corrections: d, h this report references a us equivalent device.The us udi equivalent for this product number is used.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.
 
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Brand Name
BARDEX® LUBRICATH® HEMATURIA FOLEY CATHETER
Common Device Name
FOLEY 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 GA 30014
Manufacturer Contact
xeeroy rada
8195 industrial blvd
covington, GA 30014
7707846100
MDR Report Key22234825
Report Number1018233-2025-04659
Device Sequence Number18428658
Product Code KOD
UDI-Device Identifier00801741025143
UDI-Public(01)00801741025143(11)241206(17)290728(10)MYJX4889
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K922431
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,User Facility
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 11/11/2025
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 Number2551H20
Device Lot NumberMYJX4889
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/30/2025
Supplement Date Received by Manufacturer11/11/2025
Initial Report FDA Received Date06/17/2025
Supplement Report FDA Received Date11/18/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/06/2024
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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