FDA Adverse Event Other Summary report: N

COUNCIL TIP CATHETER

MDR report key: 17594972 · Received August 21, 2023

Report

Report Number
MW5144815
Event Type
Other
Date Received
August 21, 2023
Date of Event
August 18, 2023
Report Date
August 18, 2023
Manufacturer
BARD/C.R. BARD, INC.
Product Code
MJC
Report Source
Voluntary report
Reporter Location
AL, US
Reporter Occupation
RISK MANAGER
Health Professional
Yes

Narratives

Description of Event or Problem · 0

SURGEON PERFORMED RIGHT URETEROSCOPY, HOLMIUM LASER LITHOTRIPSY, RIGHT STONE BASKET EXTRACTION, RIGHT URETERAL STENT PLACEMENT AND COMPLEX FOLEY CATHETER PLACEMENT FOR A LARGE RIGHT URETERAL STONE. THE PRODUCT MALFUNCTION WAS DURING THE COMPLEX FOLEY CATHETER PLACEMENT. THE SURGEON REQUESTED A 20 FR COUNCIL TIP CATHETER WHICH WAS SUPPLIED. UPON PLACING THE BALLOON FAILED AND UPON REMOVING FROM PATIENT IT WAS DETERMINED THAT IT HAD A VERY TINY PIN HOLE IN IT. A SECOND 20 FR COUNCIL TIP WAS SUPPLIED AND WHEN PLACED THE BALLOON WOULD NOT INFLATE. I PERSONALLY LOOKED AT PACKAGING AND NOTICED BOTH WERE FROM SAME LOT SO I RETRIEVED A THIRD 20 FR COUNCIL TIP CATHETER FOR SURGEON FROM A DIFFERENT LOT WHICH WAS PLACED AND BALLOON INFLATED PROPERLY. ALL 20 FR COUNCIL TIP CATHETERS IN THE LOT THAT HAD ISSUE WERE PULLED FROM SHELF. REFERENCE REPORT: MW5144816.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1035633 COUNCIL TIP CATHETER CATHETER, UROLOGICAL (ANTIMICROBIAL) AND ACCESSORIES MJC BARD/C.R. BARD, INC. 0196SI20 NGHS0500

Patients

Seq Age Sex Outcome Treatment
1 Unknown