FDA Adverse Event Malfunction Summary report: N

BARDEX® LUBRI-SIL® I.C. TEMPERATURE-SENSING ALL-SILICONE FOLEY CATHETER

MDR report key: 22589004 · Received July 24, 2025

Report

Report Number
1018233-2025-06117
Event Type
Malfunction
Date Received
July 24, 2025
Date of Event
July 10, 2025
Report Date
December 19, 2025
Manufacturer
C.R. BARD INC. (COVINGTON) -1018233
Product Code
MJC
UDI-DI
00801741039843
PMA / PMN Number
K070582
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
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. UDI FORMAT UPDATED WITH AVAILABLE PRODUCT INFORMATION PER GUDID. 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 IS CONFIRMED VIA CAPA ASSOCIATED. THIS IS ADDRESSED BY CAPA 12474540. PHOTO SAMPLES WERE SUBMITTED SHOWING THE DEFLATED CATHETER. NO VISIBLE DEFECTS WERE NOTED FROM THE PHOTOS. THE ALL-SILICONE TEMP SENSING FOLEY CATHETER WITH SAMPLE PORT CONNECTOR, SYRINGE AND PACKAGING LABEL WERE RETURNED. THE CATHETER BALLOON WAS INFLATED WITH 10ML METHYLENE BLUE SOLUTION (MBS) USING THE RETURNED SYRINGE. THE BALLOON WAS NOTED TO INFLATE ASYMMETRICALLY (100:0) PER TM0300903 REV 3; THIS FAILURE IS DOCUMENTED AND INVESTIGATED VIA CAPA 11291030. AN ATTEMPT WAS MADE TO DEFLATE THE CATHETER BALLOON, HOWEVER, ONLY 1ML DEFLATED IN 5 MINUTES. PER IP7603444 REVISION 0, THE CATHETER MUST INFLATE AND DEFLATE WITH A SYRINGE. THE CATHETER BALLOON WAS THEN INFLATED WITH 10ML MBS USING AN IN-HOUSE SYRINGE, THE BALLOON PASSIVELY DEFLATED IN 01MIN37SEC. THE REPORTED EVENT IS CONFIRMED AGAINST THE RETURNED SYRINGE. CAPA 12474540 IDENTIFIED THE ROOT CAUSE OF THIS FAILURE AS A COMBINATION OF THREE (3) FACTORS; PROVIDED WATER SYRINGE DOES NOT MEET USER EXPECTATION FOR SMOOTH ENGAGEMENT WITH THE VALVE AND NO INSTRUCTIONS ARE PROVIDED IN THE JAPANESE IFU FOR ASPIRATING TO ASSIST IN DEFLATION, DEFLATION TIME OR TAKE OFF FORCE CRITERIA OR SPECIFICATION TO DEFLATE THE CATHETER HAS NOT BEEN DETERMINED AND IT IS UNKNOWN FOR THE CUSTOMERS, INADEQUATE PROCESS QUALIFICATION PERFORMED WITH CHANGE IN SYRINGE SUPPLIER AND MOLD CHANGE. RISK REVIEW, LABELING REVIEW, AND DHR REVIEW ARE NOT REQUIRED AS EVENT HAS ALREADY BEEN INVESTIGATED PER CAPA 12474540, HOWEVER, DHR REVIEW WAS COMPLETED PRIOR TO CAPA DETERMINATION. REFER TO CAPA 12474540 FOR FURTHER DETAILS. UDI FORMAT UPDATED WITH AVAILABLE PRODUCT INFORMATION PER GUDID. INITIAL REPORTER NAME: (B)(6). 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 THE STERILE WATER OF FOLEY CATHETER DID NOT DRAIN WHEN THE BALLOON WAS CHECKED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE STERILE WATER OF FOLEY CATHETER DID NOT DRAIN WHEN THE BALLOON WAS CHECKED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1859461 BARDEX® LUBRI-SIL® I.C. TEMPERATURE-SENSING ALL-SILICONE FOLEY CATHETER TEMPERATURE SENSING FOLEY CATHETER MJC C.R. BARD INC. (COVINGTON) -1018233 MYKN5225 00801741039843

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other