FDA Adverse Event Malfunction Summary report: N

BARD 5CC ECONOMY LUBRICATH LATEX FOLEY CATHETER WITH 5CC BALLOON

MDR report key: 6148324 · Received December 6, 2016

Report

Report Number
1018233-2016-01757
Event Type
Malfunction
Date Received
December 6, 2016
Date of Event
November 18, 2016
Report Date
April 13, 2017
Manufacturer
BARD SDN. BHD. -8040607
Product Code
EZC
PMA / PMN Number
K910846
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS STILL IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE A SUPPLEMENTAL REPORT WILL BE FILED. THE INFORMATION PROVIDED BY BARD REPRESENTS ALL OF 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 BARD.

Additional Manufacturer Narrative · 1

SAMPLE WAS EVALUATED AND NO PINCH OR BLOCKAGE OBSERVED. ABLE TO INTRODUCE WATER IN ALL RETURNED PIECES. NO CONDITIONS FOUND ON SAMPLE THAT COULD BE ASSOCIATED WITH REPORTED EVENT. DUE TO POOR CONDITION OF THE RETURNED SAMPLE, A COMPLETE EVALUATION COULD NOT BE PERFORMED. OBSERVED SALT ACCUMULATION. THE DEVICE HISTORY RECORD WAS REVIEWED AND FOUND NOTHING THAT COULD HAVE CAUSED OR CONTRIBUTED TO THE REPORTED EVENT. THE INSTRUCTIONS FOR USE STATE THE FOLLOWING: "TO DEFLATE CATHETER BALLOON: GENTLY INSERT A SYRINGE IN THE CATHETER VALVE. NEVER USE MORE FORCE THAN IS REQUIRED TO MAKE THE SYRINGE "STICK" IN THE VALVE. IF YOU NOTICE SLOW OR NO DEFLATION, RE-SEAT THE SYRINGE GENTLY. USE ONLY GENTLE ASPIRATION TO ENCOURAGE DEFLATION IF NEEDED. VIGOROUS ASPIRATION MAY COLLAPSE THE INFLATION LUMEN, PREVENTING BALLOON DEFLATION. IF PERMITTED BY HOSPITAL PROTOCOL, THE VALVE ARM MAY BE SEVERED. IF THIS FAILS, CONTACT AND ADEQUATELY TRAINED PROFESSIONAL FOR ASSISTANCE, AS DIRECTED BY HOSPITAL PROTOCOL." (B)(4). THE INFORMATION PROVIDED BY BARD REPRESENTS ALL OF 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 BARD.

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS STILL IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE A SUPPLEMENTAL REPORT WILL BE FILED. THE INFORMATION PROVIDED BY BARD REPRESENTS ALL OF 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 BARD.

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS STILL IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE, A SUPPLEMENTAL REPORT WILL BE FILED.

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS STILL IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE A SUPPLEMENTAL REPORT WILL BE FILED. THE INFORMATION PROVIDED BY BARD REPRESENTS ALL OF 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 BARD.

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS STILL IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE A SUPPLEMENTAL REPORT WILL BE FILED. THE INFORMATION PROVIDED BY BARD REPRESENTS ALL OF 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 BARD.

Description of Event or Problem · 1

IT WAS REPORTED THAT, DURING A PRE-TEST, THE BALLOON ALLEGEDLY WOULD NOT DEFLATE. THE SYRINGE WAS CLEARLY MARKED ¿FOR INFLATION ONLY¿.

Description of Event or Problem · 1

IT WAS REPORTED THAT, DURING A PRE-TEST, THE BALLOON ALLEGEDLY WOULD NOT DEFLATE. THE SYRINGE WAS CLEARLY MARKED ¿FOR INFLATION ONLY¿.

Description of Event or Problem · 1

IT WAS REPORTED THAT, DURING A PRE-TEST, THE BALLOON WOULD NOT DEFLATE. THE BALLOON WOULD NOT DEFLATE AFTER THE BALLOON WAS "TEST INFLATED". THE SYRINGE WAS CLEARLY MARKED ¿FOR INFLATION ONLY¿.

Description of Event or Problem · 1

IT WAS REPORTED THAT, DURING A PRE-TEST, THE BALLOON WOULD NOT DEFLATE. THE BALLOON WOULD NOT DEFLATE AFTER THE BALLOON WAS "TEST INFLATED". THE SYRINGE WAS CLEARLY MARKED ¿FOR INFLATION ONLY¿.

Description of Event or Problem · 1

IT WAS REPORTED THAT, DURING A PRE-TEST, THE BALLOON ALLEGEDLY WOULD NOT DEFLATE. THE SYRINGE WAS CLEARLY MARKED ¿FOR INFLATION ONLY¿.

Description of Event or Problem · 1

IT WAS REPORTED THAT, DURING A PRE-TEST, THE BALLOON ALLEGEDLY WOULD NOT DEFLATE. THE SYRINGE WAS CLEARLY MARKED ¿FOR INFLATION ONLY¿.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
798310 BARD 5CC ECONOMY LUBRICATH LATEX FOLEY CATHETER WITH 5CC BALLOON CATHETER EZC BARD SDN. BHD. -8040607 6AJ7055

Patients

Seq Age Sex Outcome Treatment
1