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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDLINE INDUSTRIES, LP; CATHETER,FOLEY,100%SILICONE,24FR,10ML,LF

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MEDLINE INDUSTRIES, LP; CATHETER,FOLEY,100%SILICONE,24FR,10ML,LF Back to Search Results
Catalog Number DYND11506H
Medical Device Problem Code Fluid/Blood Leak (1250)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
It was reported that a foley catheter was leaking and had to be replaced.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
It was reported that a foley catheter was leaking and had to be replaced.
 
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Common Device Name
CATHETER,FOLEY,100%SILICONE,24FR,10ML,LF
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 Key22884896
Report Number1417592-2025-00407
Device Sequence Number4849580
Product Code EZL
UDI-Device Identifier10080196848829
UDI-Public10080196848829
Combination Product (Y/N)N
Initial Reporter StateSC
Initial Reporter CountryUS
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 Administrator/Supervisor
Type of Report Initial
Report Date (Section B) 08/25/2025
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 Catalogue NumberDYND11506H
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/30/2025
Initial Report FDA Received Date08/25/2025
Was Device Evaluated by Manufacturer? (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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