FDA Adverse Event Injury Summary report: N

UNKNOWN LATEX TEMP-SENSING CATHETER

MDR report key: 22078275 · Received May 23, 2025

Report

Report Number
1018233-2025-03821
Event Type
Injury
Date Received
May 23, 2025
Date of Event
April 21, 2025
Report Date
June 13, 2025
Manufacturer
C.R. BARD, INC. (COVINGTON) -1018233
Product Code
EZC
PMA / PMN Number
K910846
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE REPORTED EVENT WAS INCONCLUSIVE BECAUSE THIS INVESTIGATION DID NOT RESULT IN ANY ADDITIONAL FINDINGS, AND NO SAMPLE WAS AVAILABLE FOR EVALUATION. NO ACTIONS CAN BE TAKEN AT THIS TIME SINCE A ROOT CAUSE WAS NOT IDENTIFIED. A DHR REVIEW IS NOT REQUIRED AS THE LOT NUMBER IS UNKNOWN. THE PRODUCT CATALOG NUMBER AND THE LOT NUMBER FOR THIS DEVICE ARE UNKNOWN. THEREFORE, BD IS UNABLE TO DETERMINE THE ASSOCIATED LABELING TO REVIEW. THE REPORTED PRODUCT NUMBER IS UNKNOWN. THE UDI NUMBER FOR THIS PRODUCT IS NOT AVAILABLE. 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. THE REPORTED PRODUCT NUMBER IS UNKNOWN. THE UDI NUMBER FOR THIS PRODUCT IS NOT AVAILABLE. 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 REGISTERED NURSE CAME INTO ROOM TO GIVE PATIENT MEDICATIONS. PATIENT COMPLAINING OF SUDDEN SHARP PAIN AT UNKNOWN LATEX TEMPERATURE SENSING CATHETER INSERTION SITE AFTER ASSESSED PATIENT, REGISTERED NURSE FOUND FOLEY NEXT TO PATIENT WITH BALLOON NOT INTACT. PAIN MEDICATION GIVEN TO PATIENT AND PHYSICIAN NOTIFIED. PATIENT IS A 29-YR FEMALE ADMITTED IN 2025 AS A TRAUMA ALERT STATUS POST BEEN STRUCK BY A VEHICLE WHILE ON A MOPED. THIS IS REPORTED AS THE THIRD TEMP SENSING FOLEY BALLOON THAT HAD RUPTURED IN A PATIENT RECEIVING GENTAMYCIN IRRIGATION. SEE NOTES FOR ADDITIONAL INFORMATION REGARDING COMPATIBILITY BETWEEN FOLEY AND GENTAMYCIN SOLUTION. CONFIRMED THAT GENTAMYCIN IRRIGATION SOLUTION WAS PREPARED IN LUER LOCK SYRINGE AND PLACED THROUGH THE PORT LOCATED AT THE TOP OF THE DRAINAGE TUBING. SEVERITY OF EVENT, EVENT REACHED PATIENT AND NO HARM OR NO DETECTABLE HARM.

Description of Event or Problem · 0

IT WAS REPORTED THAT REGISTERED NURSE CAME INTO ROOM TO GIVE PATIENT MEDICATIONS. PATIENT COMPLAINING OF SUDDEN SHARP PAIN AT UNKNOWN LATEX TEMPERATURE SENSING CATHETER INSERTION SITE AFTER ASSESSED PATIENT, REGISTERED NURSE FOUND FOLEY NEXT TO PATIENT WITH BALLOON NOT INTACT. PAIN MEDICATION GIVEN TO PATIENT AND PHYSICIAN NOTIFIED. PATIENT IS A 29-YR FEMALE ADMITTED IN 2025 AS A TRAUMA ALERT STATUS POST BEEN STRUCK BY A VEHICLE WHILE ON A MOPED. THIS IS REPORTED AS THE THIRD TEMP SENSING FOLEY BALLOON THAT HAD RUPTURED IN A PATIENT RECEIVING GENTAMYCIN IRRIGATION. SEE NOTES FOR ADDITIONAL INFORMATION REGARDING COMPATIBILITY BETWEEN FOLEY AND GENTAMYCIN SOLUTION. CONFIRMED THAT GENTAMYCIN IRRIGATION SOLUTION WAS PREPARED IN LUER LOCK SYRINGE AND PLACED THROUGH THE PORT LOCATED AT THE TOP OF THE DRAINAGE TUBING. SEVERITY OF EVENT, EVENT REACHED PATIENT AND NO HARM OR NO DETECTABLE HARM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1069905 UNKNOWN LATEX TEMP-SENSING CATHETER UNKNOWN TEMPERATURE SENSING FOLEY CATHETER EZC C.R. BARD, INC. (COVINGTON) -1018233 UNK

Patients

Seq Age Sex Outcome Treatment
1 29 YR Female Required Intervention