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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDLINE INDUSTRIES, LP MEDLINE; 1LYR TRY 16FR 10ML 100% SILI UM SNAP

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MEDLINE INDUSTRIES, LP MEDLINE; 1LYR TRY 16FR 10ML 100% SILI UM SNAP Back to Search Results
Catalog Number URO175816
Medical Device Problem Code Deflation Problem (1149)
Health Effect - Clinical Code Genital Bleeding (4507)
Date of Event 04/01/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
It was reported that upon deflation of a catheter, "there was still a tiny amount of air inflated in the balloon".The customer contact reported, "connected a sterile syringe to the balloon port and allowed 9.5ml to naturally backflow into the syringe.Then pulled back with the syringe to double-check if there was any more air or water left in the balloon.Pulled back 2 additional times to verify there was nothing left in the balloon.Catheter pulled out with no resistance.When it was completely out, there was still a tiny amount of air inflated in the balloon.Pt bled from his urethra for a few minutes afterwards and then resolved".There were no reports of death, serious injury, medical intervention, or follow-up care.It has been determined that the event did not involve a death or serious injury; however, it meets the definition of a reportable malfunction, as recurrence of the malfunction could cause or contribute to death or serious injury.Based on the information reviewed, this is a reportable event as defined under 21 cfr 803.3.
 
Event or Problem Description
It was reported that upon deflation of a catheter, "there was still a tiny amount of air inflated in the balloon".
 
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Brand Name
MEDLINE
Common Device Name
1LYR TRY 16FR 10ML 100% SILI UM SNAP
Manufacturer (Section D)
MEDLINE INDUSTRIES, LP
three lakes drive
northfield IL 60093
Manufacturer Contact
sabrina surmaj
three lakes drive
northfield, IL 60093
MDR Report Key25354665
Report Number1417592-2026-01949
Device Sequence Number13425403
Product Code PPB
UDI-Device Identifier10193489987461
UDI-Public10193489987461
Combination Product (Y/N)N
Initial Reporter StateTN
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 Risk Manager
Type of Report Initial
Report Date (Section B) 06/01/2026
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 NumberURO175816
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/05/2026
Initial Report FDA Received Date06/01/2026
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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