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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDLINE INDUSTRIES, LP; 1LYRTR 16FR10ML LATEX DB SNAP

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MEDLINE INDUSTRIES, LP; 1LYRTR 16FR10ML LATEX DB SNAP Back to Search Results
Catalog Number URO175116
Medical Device Problem Codes Leak/Splash (1354); Mechanical Problem (1384)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/16/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the clinician had "difficulty securing the syringe to the catheter for balloon inflation" and "more force was needed to insert the syringe".
 
Additional Manufacturer Narrative
It was reported that the clinician had "difficulty securing the syringe to the catheter for balloon inflation" and "more force was needed to insert the syringe".The customer reported that the incident led to "leakage" causing the foley balloon to not be "fully inflated".The customer reported that the incident did not lead to any patient harm, and no follow up care was required related to the reported incident.No additional details are available related to the customer reported issue.To date, no information has been received to indicate that a user or a patient experienced a death, serious injury, medical intervention, follow-up care, or other adverse health impact associated with the reported problem/issue.In an abundance of caution, and in response to an fda 483 issued for cfn (b)(4) on 22-jan-2024, this medwatch is being filed for the reported problem/issue.If additional relevant information becomes available a supplemental medwatch will be filed.
 
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Common Device Name
1LYRTR 16FR10ML LATEX DB SNAP
Manufacturer (Section D)
MEDLINE INDUSTRIES, LP
three lakes drive
northfield IL 60093
Manufacturer Contact
danielle tognocchi
three lakes drive
northfield, IL 60093
MDR Report Key23291212
Report Number1417592-2025-00550
Device Sequence Number13269005
Product Code OHR
UDI-Device Identifier10193489987294
UDI-Public10193489987294
Combination Product (Y/N)N
Initial Reporter StateMN
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 Other
Type of Report Initial
Report Date (Section B) 10/14/2025
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 NumberURO175116
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/16/2025
Initial Report FDA Received Date10/15/2025
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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