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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 Fracture (1260); Difficult to Remove (1528); Deformation Due to Compressive Stress (2889); Physical Resistance/Sticking (4012)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/23/2026
Type of Reportable Event Malfunction
Event or Problem Description
On (b)(6) 2026, a patient underwent a chronic catheter placement procedure using a broviac cv catheter.During the procedure, upon removal of the guidewire from its packaging, the tip was observed to be bent.The healthcare professional manually straightened the guidewire and proceeded with use.Following vascular puncture and guidewire insertion, the guidewire became stuck and subsequently fractured during removal.There was no reported patient injury.
 
Additional Manufacturer Narrative
H11: as the lot number for the device was provided, a review of the device history records is currently being performed.The device has been returned to the manufacturer for evaluation.The investigation of the reported event is currently underway.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.
 
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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
+1(480)303-2689
MDR Report Key50837694
Report Number3006260740-2026-06836
Device Sequence Number18629284
Product Code LJS
UDI-Device Identifier00801741051807
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K830256
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Foreign,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
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 Number0600520
Device Lot NumberHULN1249
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer09/14/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/28/2026
Initial Report FDA Received Date09/21/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
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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