FDA Adverse Event Malfunction Summary report: N

DAVOL® PEDIATRIC CATH KIT

MDR report key: 19475700 · Received June 6, 2024

Report

Report Number
1018233-2024-03321
Event Type
Malfunction
Date Received
June 6, 2024
Date of Event
March 15, 2024
Report Date
July 18, 2024
Manufacturer
C.R. BARD INC. (COVINGTON) -1018233
Product Code
FFH
UDI-DI
00801741045851
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

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.

Additional Manufacturer Narrative · 0

THE REPORTED EVENT WAS CONFIRMED CAUSE UNKNOWN. VISUAL EVALUATION OF THE RETURNED SAMPLE NOTED TWO OPENED (WITHOUT ORIGINAL PACKAGING), CATHETER STENT AND A CATHETER KIT. VISUAL INSPECTION OF THE SAMPLE NOTED ONE CATHETER STENT HAD FELL OUT OF THE COLLECTION CONTAINER ALTHOUGH A ROOT CAUSE COULD NOT BE DEFINITIVELY IDENTIFIED, BASED ON THE RISK DOCUMENTATION REVIEW, A POTENTIAL ROOT CAUSE FOR THIS TYPE OF FAILURE COULD BE ¿INLET PORT OF THE CAP / CATHETER (FR.) THICKNESS OUT OF SPECIFICATION". HOWEVER, THERE WAS INSUFFICIENT INFORMATION TO CONFIRM THIS POTENTIAL ROOT CAUSE A REVIEW OF THE DEVICE HISTORY RECORD DID NOT SHOW ANY PROBLEMS OR CONDITIONS THAT WOULD HAVE CONTRIBUTED TO THE REPORTED ISSUE. THE INSTRUCTIONS FOR USE WERE FOUND ADEQUATE AND STATE THE FOLLOWING: "INFANT AND PEDIATRIC CATH KITS: INFORMATION FOR USE: CAUTION: READ ALL INSTRUCTIONS PRIOR TO USE. INDICATIONS: BLADDER CATHETERIZATION IS PERFORMED WHEN A STERILE URINE SAMPLE IS NEEDED AND A CLEAN CATCH SPECIMEN CANNOT BE OBTAINED. WARNINGS: THE CATHETER SHOULD NEVER BE FORCED IF RESISTANCE IS FELT. TRAUMA TO THE BLADDER (FALSE PASSAGE) CAN BE PREVENTED BY ADEQUATELY LUBRICATING THE CATHETER AND STRETCHING THE PENIS TO STRAIGHTEN THE URETHRA. STERILE: STERILE UNLESS PACKAGE IS OPENED OR DAMAGED. CAUTION: FEDERAL (U.S.A.) LAW RESTRICTS THIS DEVICE TO SALE BY OR ON THE ORDER OF A PHYSICIAN. INSTRUCTIONS: 1. OPEN PLASTIC WALLET, WHICH MAY BE USED AS A STERILE FIELD. THE FOLLOWING FOUR STEPS APPLY ONLY TO MALE CATHETERIZATION: 2. PLACE THE INFANT SUPINE, WITH THE THIGHS ABDUCTED (FROG-LEG POSITION). 3. CLEANSE THE PENIS WITH POVIDONE-IODINE SWABS, STARTING WITH THE MEATUS AND MOVING IN A PROXIMAL DIRECTION. 4. PUT ON STERILE GLOVES. REMOVE PROTECTIVE SHEATH FROM CATHETER AND PULL CATHETER OUT OF CENTRIFUGE TUBE TO DESIRED LENGTH. LAY TUBE ASSEMBLY ON THE STERILE FIELD. 5. PLACE THE TIP OF THE CATHETER IN STERILE LUBRICANT. HOLD THE PENIS PERPENDICULAR TO THE BODY TO STRAIGHTEN THE PENILE URETHRA AND HELP PREVENT FALSE PASSAGE. ADVANCE THE CATHETER CAREFULLY UNTIL URINE APPEARS. A SLIGHT RESISTANCE MAY BE FELT AS THE CATHETER PASSES THE EXTERNAL SPHINCTER. NOTE: IF URINE DOES NOT FLOW FREELY INTO THE TUBE, THE CAP MAY NEED TO BE LOOSENED SLIGHTLY. 6. AFTER URINE IS COLLECTED, PULL CATHETER OUT OF THE CAP OF THE CENTRIFUGE TUBE. TIGHTEN CAP AND DEPRESS SPOUT. 7. FILL OUT LABEL AND PLACE ON CENTRIFUGE TUBE. SEND TO LAB IN NORMAL MANNER. INSTRUCTIONS: 1. OPEN PLASTIC WALLET, WHICH MAY BE USED AS A STERILE FIELD. THE FOLLOWING FOUR STEPS APPLY ONLY TO FEMALE CATHETERIZATION: 2. PLACE THE INFANT SUPINE, WITH THE THIGHS ABDUCTED (FROG-LEG POSITION). 3. SEPARATE THE LABIA AND CLEANSE THE AREA AROUND THE MEATUS WITH THE POVIDONE-IODINE SWABS. USE ANTERIOR-TO-POSTERIOR STROKES TO PREVENT FECAL CONTAMINATION. 4. PUT ON STERILE GLOVES. REMOVE PROTECTIVE SHEATH FROM CATHETER AND PULL CATHETER OUT OF CENTRIFUGE TUBE TO DESIRED LENGTH. LAY TUBE ASSEMBLY ON THE STERILE FIELD. 5. PLACE THE TIP OF THE CATHETER IN STERILE LUBRICANT. SPREAD THE LABIA WITH TWO FINGERS AND CAREFULLY ADVANCE THE CATHETER UNTIL URINE APPEARS. NOTE: IF URINE DOES NOT FLOW FREELY INTO THE TUBE, THE CAP MAY NEED TO BE LOOSENED SLIGHTLY. 6. AFTER URINE IS COLLECTED, PULL CATHETER OUT OF THE CAP OF THE CENTRIFUGE TUBE. TIGHTEN CAP AND DEPRESS SPOUT. 7. FILL OUT LABEL AND PLACE ON CENTRIFUGE TUBE. SEND TO LAB IN NORMAL MANNER." 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.

Description of Event or Problem · 0

IT WAS REPORTED THAT CUSTOMER HAD BEEN SEEING MULTIPLE CONCERNS ON BARD PEDIATRIC CATHETER KIT, WHERE THE STRAIGHT CATHETER KITS HAD FELL OUT OF THE COLLECTION CONTAINER. ADDITIONALLY, THEY HAD A NURSE ON A TRAVEL ASSIGNMENT, AND THEY WERE SEEING THE SAME ISSUE WITH THE SAME KITS. PER SAMPLE FORM RECEIVED ON (B)(6) 2024, IT WAS REPORTED THAT THE PATIENT NEEDED A CATHETER AND KIT WAS PULLED FROM THE CART, CATHETER TUBE SNAPPED IN HALF WHEN PULLED FROM COLLECTION TUBE.

Description of Event or Problem · 0

IT WAS REPORTED THAT CUSTOMER HAD BEEN SEEING MULTIPLE CONCERNS ON BARD PEDIATRIC CATHETER KIT, WHERE THE STRAIGHT CATHETER KITS HAD FELL OUT OF THE COLLECTION CONTAINER. ADDITIONALLY, THEY HAD A NURSE ON A TRAVEL ASSIGNMENT, AND THEY WERE SEEING THE SAME ISSUE WITH THE SAME KITS. PER SAMPLE FORM RECEIVED ON 20MAY2024, IT WAS REPORTED THAT THE PATIENT NEEDED A CATHETER AND KIT WAS PULLED FROM THE CART, CATHETER TUBE SNAPPED IN HALF WHEN PULLED FROM COLLECTION TUBE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1688492 DAVOL® PEDIATRIC CATH KIT PEDIATRIC CATHETER KIT FFH C.R. BARD INC. (COVINGTON) -1018233 NGHT2090 00801741045851

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other