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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: C.R. BARD, INC. (BASD) -3006260740 BROVIAC CV CATHETER, SINGLE-LUMEN, 4.2F; CHRONIC CATHETERS

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C.R. BARD, INC. (BASD) -3006260740 BROVIAC CV CATHETER, SINGLE-LUMEN, 4.2F; CHRONIC CATHETERS Back to Search Results
Catalog Number 0600520
Medical Device Problem Codes Material Discolored (1170); Difficult to Flush (1251); Suction Problem (2170); Air/Gas in Device (4062)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/13/2026
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 was performed.The sample has not been 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) are 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 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.
 
Event or Problem Description
A patient underwent a central venous catheter placement procedure using hickman/leonard/broviac central venous catheter.After some time, it was reported, that the external portion of the catheter tubing had turned pink, and an air bubble was observed within it, preventing aspiration and flushing.The procedure was subsequently completed using another device.There was no reported patient injury.
 
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Brand Name
BROVIAC CV CATHETER, SINGLE-LUMEN, 4.2F
Common Device Name
CHRONIC CATHETERS
Manufacturer (Section D)
C.R. BARD, INC. (BASD) -3006260740
605 north 5600 west
salt lake city 84116
Manufacturer (Section G)
BARD SHANNON LIMITED -3005636544
san geronimo industrial park
lot #1, road #3, km 79.7
humacao PR 00791
Manufacturer Contact
michael gaffney
800 w. rio salado pkwy
tempe, AZ 85281
4803032689
MDR Report Key25371035
Report Number3006260740-2026-03842
Device Sequence Number9279713
Product Code LJS
UDI-Device Identifier00801741051807
UDI-Public(01)00801741051807(11)260113(17)280328(10)HUKY0590
Combination Product (Y/N)N
Initial Reporter StateMN
Initial Reporter CountryUS
PMA/510(K) Number
K830256
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) 07/01/2026
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 Number0600520
Device Lot NumberHUKY0590
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 05/13/2026
Supplement Date Received by Manufacturer07/01/2026
Initial Report FDA Received Date06/03/2026
Supplement Report FDA Received Date07/03/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured01/13/2026
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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