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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: C.R. BARD INC. (COVINGTON) -1018233 CLOSED WOUND SUCTION; WOUND DRAIN

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C.R. BARD INC. (COVINGTON) -1018233 CLOSED WOUND SUCTION; WOUND DRAIN Back to Search Results
Catalog Number 0070740
Medical Device Problem Code Device Contamination with Chemical or Other Material (2944)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/06/2025
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.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 there was debris and hairs in the silicone drain evacuator.
 
Additional Manufacturer Narrative
The reported event is confirmed manufacturing related.Visual evaluation noted visual inspection noted foreign material measuring.80mm^2 and located inside the packaging.Therefore, the reported event is confirmed and does not meet specifications per ip7600139 rev 12 which states "the product/assembly must be free of visible, lose or etched foreign matter, solvent spills, hair, etc." a labeling review was not performed because labeling could not have prevented the reported failure.A dhr review is not required as the lot number is unknown.Based on the results of the investigation no additional actions are required 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 there was debris and hairs in the silicone drain evacuator.Per customer via email on (b)(6) 2025 it was reported that a total of 17 silicone drain evacuators contained debris.Sample is available.Pending sample return.No further details were provided.Per sample evaluation, foreign material was found.Lot: ngkq0974; release date: 04/09/2025; expiration date: 02/28/2030.
 
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Brand Name
CLOSED WOUND SUCTION
Common Device Name
WOUND DRAIN
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 Key22749016
Report Number1018233-2025-06604
Device Sequence Number20991011
Product Code GCY
UDI-Device Identifier00801741049569
UDI-Public(01)00801741049569(11)241112(17)290930(10)NGJX3113
Combination Product (Y/N)N
Initial Reporter StateMI
Initial Reporter CountryUS
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 11/07/2025
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 Number0070740
Device Lot NumberNGJX3113
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 08/06/2025
Supplement Date Received by Manufacturer11/07/2025
Initial Report FDA Received Date08/08/2025
Supplement Report FDA Received Date11/18/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured11/22/2024
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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