| Brand Name | Bardex® Lubri-Sil® I.C. All-Silicone Foley Catheter |
| Common Device Name | Foley Catheter |
| 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 Key | 25826318 |
| Report Number | 1018233-2026-04666 |
| Device Sequence Number | 21285806 |
| Product Code |
EZL
|
| UDI-Device Identifier | 00801741025242 |
| Combination Product (Y/N) | Y |
| Initial Reporter State | NY |
| Initial Reporter Country | US |
| PMA/510(K) Number | K040504 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Other,Company Representative,Distributor |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
07/22/2026 |
| 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 Number | 1758SI20 |
| Device Lot Number | NGKT1853 |
| Was Device Available for Evaluation? |
No
|
| 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 | 07/09/2026 |
| Supplement Date Received by Manufacturer | 07/22/2026
|
| Initial Report FDA Received Date | 07/15/2026 |
| Supplement Report FDA Received Date | 07/27/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 09/30/2025 |
| 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 Number | 1 |
| Outcome Attributed to Adverse Event |
Other;
|
| Patient Sex | Unknown |