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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: C.R. BARD INC. (COVINGTON) -1018233 SureStep¿ Foley Tray System Lubri-Sil® IC Complete Care®

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C.R. BARD INC. (COVINGTON) -1018233 SureStep¿ Foley Tray System Lubri-Sil® IC Complete Care® Back to Search Results
Catalog Number A303416A
Medical Device Problem Code Difficult to Remove (1528)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/07/2026
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: 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
It was reported that the foley catheter had balloon that could not be deflated, and physicians had to remove catheter while balloon was still inflated.
 
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Brand Name
SureStep¿ Foley Tray System Lubri-Sil® IC Complete Care®
Common Device Name
Foley Tray
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 GA 30014
Manufacturer Contact
xeeroy rada
8195 industrial blvd
covington, GA 30014
+1(770)784-6100
MDR Report Key25622649
Report Number1018233-2026-04130
Device Sequence Number8983820
Product Code EZL
UDI-Device Identifier00801741073823
UDI-Public(01)00801741073823(11)250623(17)300616(10)NGKS5464
Combination Product (Y/N)Y
Initial Reporter StateGA
Initial Reporter CountryUS
PMA/510(K) Number
K040504
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 09/01/2026
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 NumberA303416A
Device Lot NumberNGKS5464
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer07/28/2026
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/19/2026
Supplement Date Received by ManufacturerNot provided
Initial Report FDA Received Date06/25/2026
Supplement Report FDA Received Date09/04/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/23/2025
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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