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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDLINE INDUSTRIES, LP; TTL1LYR 14FR10ML 100%SILI UM TRAY

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MEDLINE INDUSTRIES, LP; TTL1LYR 14FR10ML 100%SILI UM TRAY Back to Search Results
Catalog Number URO170814
Medical Device Problem Code Fluid/Blood Leak (1250)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/16/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
A urine collection bag on a foley catheter was leaking and a new catheter was placed.It has been determined that the reported event could cause or contribute to serious injury if it were to occur.In an abundance of caution, this medwatch is being filed.If any further relevant information is identified or obtained, a supplemental medwatch will be submitted.
 
Event or Problem Description
A urine collection bag on a foley catheter was leaking and a new catheter was placed.
 
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Common Device Name
TTL1LYR 14FR10ML 100%SILI UM TRAY
Manufacturer (Section D)
MEDLINE INDUSTRIES, LP
three lakes dr
northfield IL 60093
Manufacturer Contact
gavin-ainsley nadong
three lakes dr
northfield, IL 60093
MDR Report Key22579949
Report Number1417592-2025-00349
Device Sequence Number7157741
Product Code OHR
UDI-Device Identifier10888277866645
UDI-Public10888277866645
Combination Product (Y/N)N
Initial Reporter CountryTC
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 07/23/2025
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? No
Operator of Device Health Professional
Device Expiration Date09/30/2025
Device Catalogue NumberURO170814
Device Lot Number24IBL633, 24JBI586
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 05/19/2025
Initial Report FDA Received Date07/23/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured09/18/2024
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Unknown
Patient Sequence Number1
Outcome Attributed to Adverse Event Other;
Patient SexUnknown
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