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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: C.R. BARD INC. (COVINGTON) -1018233 BARD® X-FORCE® BALLOON DILATION CATHETER

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C.R. BARD INC. (COVINGTON) -1018233 BARD® X-FORCE® BALLOON DILATION CATHETER Back to Search Results
Catalog Number 998706
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/24/2025
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: 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 during the procedure, the balloon dilation catheter balloon was opened and found to be damaged, with the pressure pump leaking.They replaced with a new balloon.
 
Additional Manufacturer Narrative
The reported event was unconfirmed.Visual inspection of the sample noted one inflation device and inflator tray was returned in its tray, inside a plastic zip lock bag.The device exhibits the cts mark indicating 100 percent functional verification at the time of manufacture, and the gauge was in the zero box upon arrival.Functional testing per wi arb-cd 0835 was attempted: the device was connected to the pressure indicator, and the plunger was pulled outwards to fill the device with distilled water to aspirate it.While aspirating the device was attempted, water began seeping out from the glue plug/clamp area.No root cause could be found because the reported event was unconfirmed.As the reported event is unconfirmed, a risk review is not required.As the reported event is unconfirmed, a labeling review is not required.A device history record review was not required as the investigation was unconfirmed.The investigation is concluded, and no additional action is required at this time.Corrections: d, f, 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 during the procedure, the balloon dilation catheter balloon was opened and found to be damaged, with the pressure pump leaking.They replaced with a new balloon.
 
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Brand Name
BARD® X-FORCE® BALLOON DILATION CATHETER
Common Device Name
DILATION 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 30014
Manufacturer Contact
xeeroy rada
8195 industrial blvd
covington, GA 30014
7707846100
MDR Report Key23708792
Report Number1018233-2025-10728
Device Sequence Number10720294
Product Code EZN
UDI-Device Identifier10801741052740
UDI-Public(01)10801741052740(11)240827(17)270105(10)BMJVFM33
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K050875
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 03/11/2026
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 Number998706
Device Lot NumberBMJVFM33
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/24/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 11/24/2025
Supplement Date Received by Manufacturer03/11/2026
Initial Report FDA Received Date12/03/2025
Supplement Report FDA Received Date03/13/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/27/2024
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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