FDA Adverse Event Injury Summary report: N

POLYURETHANE URETERAL CATHETER

MDR report key: 1954612 · Received December 17, 2010

Report

Report Number
1018233-2010-00144
Event Type
Injury
Date Received
December 17, 2010
Report Date
November 18, 2010
Manufacturer
C.R. BARD, INC.
Product Code
EYB
PMA / PMN Number
PRE-AM
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS NOT BEEN RETURNED FOR EVALUATION. THE LOT NUMBER WAS NOT PROVIDED, THEREFORE, THE DEVICE HISTORY RECORD COULD NOT BE REVIEWED. THE DIRECTIONS FOR USE STATES IN THE CAUTION SECTION: "DO NOT WITHDRAW URETERAL CATHETER WHILE IT IS DEFLECTED IN ENDOSCOPE. AVOID SHARP BENDING." (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT ON (B)(6), 2009, A PT HAD URETERAL CATHETERS PLACED DURING A SURGERY AND REMOVED AT THE END OF THE SURGERY. IN (B)(6) 2010, THE PT WAS FOUND TO HAVE A MICRO-HEMATURIA. AN X-RAY CONFIRMED THE PRESENCE OF A FOREIGN BODY. THE PT WAS TAKEN TO INTERVENTIONAL RADIOLOGY TO REMOVE AND RETAINED PORTION OF THE CATHETER. THE CATHETER PORTION MEASURED 10.5CM IN LENGTH.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 POLYURETHANE URETERAL CATHETER EYB C.R. BARD, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention