BEUDAMED
    FDA Adverse Event Other Summary report: N

    BARD FOLEY TRAY

    MDR report key: 1623665 · Received March 2, 2010

    Report

    Report Number
    MW5015014
    Event Type
    Other
    Date Received
    March 2, 2010
    Date of Event
    February 1, 2010
    Report Date
    March 2, 2010
    Manufacturer
    C.R. BARD INC.
    Product Code
    KOD
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IN, US
    Reporter Occupation
    BIOMEDICAL ENGINEER

    Narratives

    Description of Event or Problem · 1

    PT'S FOLEY CATHETER FELL TO THE FLOOR WHEN PT WAS STANDING. INSPECTION SHOWED THAT THE BALLOON AT THE CATHETER TIP WAS MISSING. PHYSICIAN WAS NOTIFIED IMMEDIATELY THAT BALLOON WAS MISSING. CYSTOSCOPY WAS SCHEDULED TO BE PERFORMED ON (B) (6) 2010, BUT WAS CANCELLED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BARD FOLEY TRAY FOLEY TRAY KOD C.R. BARD INC. BARDEX LUBRICATH

    Patients

    Seq Age Sex Outcome Treatment
    1 78 YR Other