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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BAXTER HEALTHCARE CORPORATION TUR IRRIGATION SET; SYSTEM, IRRIGATION, UROLOGICAL

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BAXTER HEALTHCARE CORPORATION TUR IRRIGATION SET; SYSTEM, IRRIGATION, UROLOGICAL Back to Search Results
Model Number 2C4041
Medical Device Problem Code Fluid/Blood Leak (1250)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/24/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that a y-type tur/bladder irrigation set was leaking from an unspecified location.The leak was observed while priming the set prior to patient use.There was no patient involvement.No additional information is available.
 
Additional Manufacturer Narrative
Should additional relevant information become available, a supplemental report will be submitted.
 
Additional Manufacturer Narrative
Additional information: d9, h3, h4, h6(update codes), h11.H11: the device was received for evaluation.A visual inspection was performed, and it was noted that a leak was observed between the tubing and y- vyl due to an incorrect manual assembly.The reported condition was verified.The cause of the reported condition was a manufacturing issue.A batch review was conducted and there were no deviations found related to this reported condition during the manufacture of this lot.Should additional relevant information become available, a supplemental report will be submitted.
 
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Brand Name
TUR IRRIGATION SET
Common Device Name
SYSTEM, IRRIGATION, UROLOGICAL
Manufacturer (Section D)
BAXTER HEALTHCARE CORPORATION
deerfield IL
Manufacturer (Section G)
BAXTER HEALTHCARE - CARTAGO
parque industrial de cartago
apartado no. 1-7052
cartago
CS  
Manufacturer Contact
25212 w. illinois route 120
round lake, IL 60073
2242702068
MDR Report Key24263065
Report Number1416980-2026-00476
Device Sequence Number10658592
Product Code LJH
UDI-Device Identifier00085412001067
UDI-Public(01)00085412001067(10)R24K30130(17)291202
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K960787
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 03/06/2026
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 Other
Device Model Number2C4041
Device Catalogue Number2C4041
Device Lot NumberR24K30130
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/08/2026
Supplement Date Received by Manufacturer03/06/2026
Initial Report FDA Received Date02/04/2026
Supplement Report FDA Received Date03/06/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/02/2024
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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