FDA Adverse Event Malfunction Summary report: N

DILATION PRODUCTS

MDR report key: 18266612 · Received December 5, 2023

Report

Report Number
1018233-2023-08736
Event Type
Malfunction
Date Received
December 5, 2023
Date of Event
November 27, 2023
Report Date
December 11, 2023
Manufacturer
C.R. BARD, INC. (COVINGTON) -1018233
Product Code
FBW
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE REPORTED EVENT WAS INCONCLUSIVE BECAUSE NO SAMPLE WAS RETURNED. A POTENTIAL ROOT CAUSE FOR THIS FAILURE COULD BE DUE TO "INADEQUATE MATERIAL SELECTION". THE DEVICE HISTORY RECORD REVIEW COULD NOT BE PERFORMED WITHOUT A LOT NUMBER. THE PRODUCT CATALOG NUMBER AND THE LOT NUMBER FOR THIS DEVICE ARE UNKNOWN. THEREFORE, BD IS UNABLE TO DETERMINE THE ASSOCIATED LABELING TO REVIEW. 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.

Additional Manufacturer Narrative · 0

THE INVESTIGATION IS STILL IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE A SUPPLEMENTAL REPORT WILL BE FILED. 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. H3 OTHER TEXT : THE DEVICE WAS NOT RETURNED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE FOLEY CATHETER WOULD NOT DRAIN. NO DIFFICULTY WITH INSERTION BUT WHEN PRIMARY REGISTER NURSE ATTEMPTED TO DRAIN FOLEY CATHETER FROM DEPENDENT DRAIN BAG (NOT CLEAR MEASURED COLLECTION UNIT) THE SEAL ON THE WHITE SIDE AND CLEAR SIDE OF THE BAG WAS FUSED AND WOULD NOT ALLOW FOR DRAINAGE FROM DRAIN BAG. FOLEY REMAINED IN PLACE UNTIL DELIVERY UPON WHICH TIME IT WAS REMOVED WHEN PATIENT BEGAN PUSHING. NO HARM TO PATIENT OR BABY AS FOLEY WAS IN PLACE FOR A SHORT PERIOD OF TIME (LOT#NGHV3874 ). PER ADDITIONAL INFORMATION RECEIVED VIA EMAIL ON 28NOV2023, CUSTOMER REPORTED THAT FOLEY CATHETER HAD A DEFECT (LOT#NGHU2373 ). CERVICAL DILATION BALLOON PLACED ON (B)(6) 2023 AT 1833. CERVICAL DILATION BALLOON FOUND TO BE RUPTURED AND DEFLATED UPON ASSESSMENT. PER ADDITIONAL INFORMATION RECEIVED VIA EMAIL ON 30NOV2023, CUSTOMER REPORTED TWO COMPLAINTS ABOUT FOLEY CATHETERS. BOTH COMPLAINTS WERE REGARDING A FOLEY BAG BEING FUSED TOGETHER (CLEAR PLASTIC PART AND WHITE PLASTIC PART) WHICH WOULD NOT ALLOW URINE TO FILL THE ENTIRE BAG (PCN#-153204 - LOT#NGHV3874 AND PCN#153204 - LOT#NGHV3874 ).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE FOLEY CATHETER WOULD NOT DRAIN. NO DIFFICULTY WITH INSERTION BUT WHEN PRIMARY REGISTER NURSE ATTEMPTED TO DRAIN FOLEY CATHETER FROM DEPENDENT DRAIN BAG (NOT CLEAR MEASURED COLLECTION UNIT) THE SEAL ON THE WHITE SIDE AND CLEAR SIDE OF THE BAG WAS FUSED AND WOULD NOT ALLOW FOR DRAINAGE FROM DRAIN BAG. FOLEY REMAINED IN PLACE UNTIL DELIVERY UPON WHICH TIME IT WAS REMOVED WHEN PATIENT BEGAN PUSHING. NO HARM TO PATIENT OR BABY AS FOLEY WAS IN PLACE FOR A SHORT PERIOD OF TIME (LOT#NGHV3874). PER ADDITIONAL INFORMATION RECEIVED VIA EMAIL ON (B)(6) 2023, CUSTOMER REPORTED THAT FOLEY CATHETER HAD A DEFECT (LOT#NGHU2373). CERVICAL DILATION BALLOON PLACED ON(B)(6) 2023 AT 1833. CERVICAL DILATION BALLOON FOUND TO BE RUPTURED AND DEFLATED UPON ASSESSMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2197274 DILATION PRODUCTS DILATION PRODUCTS FBW C.R. BARD, INC. (COVINGTON) -1018233 UNK

Patients

Seq Age Sex Outcome Treatment
1 Unknown Other