FDA Adverse Event Malfunction Summary report: N

BARD 3-WAY IRRIGATION FOLEY

MDR report key: 1855360 · Received September 30, 2010

Report

Report Number
MW5017664
Event Type
Malfunction
Date Received
September 30, 2010
Report Date
September 30, 2010
Manufacturer
BARD
Product Code
KOD
Product Problem
Yes
Report Source
Voluntary report
Reporter Location
MD, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

PT HAD A CONTINUOUS BLADDER IRRIGATION -CBI- ORDERED TO RUN AT A SPECIFIC RATE. THE CBI TUBING IS BARD 3-WAY FOLEY IRRIGATION TUBING. BECAUSE THE IRRIGATION WAS ORDERED TO RUN AT A SPECIFIC RATE, IT NEEDED TO BE INFUSED VIA AN IV PUMP. STAFF ERRONEOUSLY ATTACHED THE B BRAUN IV TUBING TO THE LUMEN OF THE FOLEY CATHETER CONTAINING THE BALLOON. THE BALLOON EVENTUALLY RUPTURED INTERNALLY. PT EXPERIENCED DISCOMFORT AND SEVERE PAIN ON REMOVAL. NO BLOOD OBSERVED. OTHERWISE PT APPEARS TO SUFFER NO ADD'L ILL EFFECTS. TUBING/FOLEY NOT FAULTY OR MALFUNCTIONING. JUST WANTED TO NOTIFY YOU THAT THE TYPE OF CONNECTIONS ALLOWED FOR A MISCONNECTION TO OCCUR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BARD 3-WAY IRRIGATION FOLEY FOLEY KOD BARD
2 B BRAUN HORIZON PUMP IV SET PUMP IV SET FPA B. BRAUN

Patients

Seq Age Sex Outcome Treatment
1