BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MAGIC3 GO MALE CATHETER

    MDR report key: 8732729 · Received June 25, 2019

    Report

    Report Number
    1018233-2019-03363
    Event Type
    Malfunction
    Date Received
    June 25, 2019
    Report Date
    July 19, 2019
    Manufacturer
    C.R. BARD, INC. (COVINGTON) -1018233
    Product Code
    EZD
    UDI-DI
    00801741137020
    PMA / PMN Number
    K172247
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    003

    Narratives

    Additional Manufacturer Narrative · 0

    THE DEVICE WAS NOT RETURNED FOR EVALUATION. A POTENTIAL ROOT CAUSE OF THIS FAILURE MODE COULD BE "OPERATOR ERROR - VISCOMETER OOC - VISCOMETER FAILURE - MECHANICAL FAILURE". THE LOT NUMBER IS UNKNOWN; THEREFORE, THE DEVICE HISTORY RECORD COULD NOT BE REVIEWED. THE INSTRUCTIONS FOR USE WERE FOUND ADEQUATE AND STATE THE FOLLOWING: "PLEASE READ ALL INSTRUCTIONS BEFORE USING THIS DEVICE. CAUTION: FEDERAL (USA) LAW RESTRICTS THIS DEVICE TO SALE BY OR ON THE ORDER OF A PHYSICIAN. DEVICE DESCRIPTION THE MAGIC3 GO® INTERMITTENT URINARY CATHETER IS A SILICONE TUBE INSERTED INTO THE URETHRA FOR THE PURPOSE OF DRAINING THE BLADDER OF URINE. NOT MADE WITH NATURAL RUBBER LATEX DOES NOT CONTAIN DEHP INDICATIONS FOR USE THE MAGIC3 GO® INTERMITTENT URINARY CATHETER IS INTENDED FOR UROLOGICAL USE ONLY. IT IS INTENDED FOR USE BY ADULT AND PEDIATRIC PATIENTS OF ALL AGES FOR BLADDER MANAGEMENT INCLUDING URINE DRAINAGE, COLLECTION, AND MEASUREMENT. THE DEVICE IS PASSED TO THE URINARY BLADDER VIA THE URETHRA. CONTRAINDICATIONS NONE KNOWN WARNINGS THIS IS A SINGLE USE DEVICE. DO NOT RESTERILIZE ANY PORTION OF THIS DEVICE. REUSE AND/OR REPACKAGING MAY CREATE A RISK OF PATIENT OR USER INFECTION, COMPROMISE THE STRUCTURAL INTEGRITY AND/OR ESSENTIAL MATERIAL AND DESIGN CHARACTERISTICS OF THE DEVICE, WHICH MAY LEAD TO DEVICE FAILURE, AND/OR LEAD TO INJURY, ILLNESS OR DEATH OF THE PATIENT. PRECAUTIONS INSPECT THE CATHETER BEFORE USE. DO NOT USE THE PRODUCT IF THE DEVICE OR PACKAGING IS DAMAGED. SELF-CATHETERIZATION SHOULD FOLLOW THE PLAN OF CARE AND ADVICE GIVEN BY YOUR HEALTHCARE PRACTITIONER AND BE CARRIED OUT ONLY IN ACCORDANCE WITH THE INSTRUCTIONS FOR USE PROVIDED. PLEASE CONSULT YOUR HEALTHCARE PRACTITIONER IF ANY CONDITIONS OCCUR WHICH CREATE CONCERN AND/OR DIFFICULTY DURING CATHETERIZATION. ADVERSE REACTIONS URINARY TRACT INFECTION BLEEDING FROM THE URETHRA IRRITATION OF THE URETHRA" H11:SECTION A THROUGH F - THE INFORMATION PROVIDED BY BD 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 BD. H3 OTHER TEXT : THE DEVICE WAS NOT RETURNED.

    Description of Event or Problem · 0

    IT WAS REPORTED THAT THE MAGIC 3 CATHETERS LACKED LUBRICANT. THE PATIENT WAS ABLE TO VOID. NO MEDICAL INTERVENTION WAS REPORTED.

    Additional Manufacturer Narrative · 1

    THE INVESTIGATION IS STILL IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE A SUPPLEMENTAL REPORT WILL BE FILED. THE DEVICE WAS NOT RETURNED.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE MAGIC 3 CATHETERS LACKED LUBRICANT. THE PATIENT WAS ABLE TO VOID. NO MEDICAL INTERVENTION WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    526608 MAGIC3 GO MALE CATHETER MAGIC 3 GO COUDE CATHETER WITH SURE GRIP EZD C.R. BARD, INC. (COVINGTON) -1018233 50814G UNK 00801741137020

    Patients

    Seq Age Sex Outcome Treatment
    1