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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: C.R. BARD, INC. (BASD) -3006260740 HEMOSTAR; DIALYSIS CATHETER

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C.R. BARD, INC. (BASD) -3006260740 HEMOSTAR; DIALYSIS CATHETER Back to Search Results
Catalog Number 5833690
Medical Device Problem Codes Fracture (1260); Air/Gas in Device (4062)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/19/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H11: as the lot number for the device was provided, a review of the device history records will be performed.The sample was not returned to the manufacturer for inspection/evaluation.Therefore, the investigation of the reported event is inconclusive.Based upon the available information, the definitive root cause for this event is unknown.The instructions for use (ifu) is adequate for the reported device/patient code(s) and provides general instructions for use, as well as warnings, precautions and potential complications associated with the device.Upon receipt of new or additional information, a follow-up report will be submitted as applicable.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
On (b)(6) 2025, a patient underwent an ultrasound-guided dialysis catheter placement procedure via the right internal jugular vein, using a hemostar hemodialysis catheter.During the procedure, it was observed that the aspirated blood revealed the presence of gas.Subsequent inspection of the puncture needle revealed a crack in the handle, causing air leakage and rendering the needle unusable.There was no reported patient injury.
 
Event or Problem Description
On (b)(6) 2025, a patient underwent an ultrasound-guided dialysis catheter placement procedure via the right internal jugular vein, using a hemostar hemodialysis catheter.During the procedure, it was observed that the aspirated blood revealed the presence of gas.Subsequent inspection of the puncture needle revealed a crack in the handle, causing air leakage and rendering the needle unusable.There was no reported patient injury.
 
Additional Manufacturer Narrative
H11: manufacturing review: the device history records have been reviewed, and this lot met all release criteria.Investigation summary: the physical device was not returned for evaluation.No photos were provided for review.Therefore, the investigation is inconclusive for the reported air/gas in device and needle handle fracture issues as no objective evidence was provided for review.The definitive root cause could not be determined based upon available information.Labeling review: as the reported event did not allege a labeling or use related issue, a labeling review is not required.D4 (unique identifier (udi) #), g3, h6 (component, method).Section a through f: the information provide 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.
 
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Brand Name
HEMOSTAR
Common Device Name
DIALYSIS CATHETER
Manufacturer (Section D)
C.R. BARD, INC. (BASD) -3006260740
605 north 5600 west
salt lake city 84116
Manufacturer (Section G)
BARD REYNOSA S.A. DE C.V. -9617592
blvd. montebello #1
parque industrial colonial
reynosa, tamaulipas 88780
MX   88780
Manufacturer Contact
brett curtice
800 w. rio salado pkwy
tempe, AZ 85281
4803032689
MDR Report Key24197258
Report Number3006260740-2026-00264
Device Sequence Number9979545
Product Code MSD
UDI-Device Identifier00801741013386
UDI-Public(01)00801741013386(11)240913(17)260630(10)REJU2989
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K051748
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 02/27/2026
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 Expiration Date06/30/2026
Device Catalogue Number5833690
Device Lot NumberREJU2989
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 01/04/2026
Supplement Date Received by Manufacturer02/27/2026
Initial Report FDA Received Date01/28/2026
Supplement Report FDA Received Date03/06/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured09/13/2024
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
Patient SexUnknown
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