FDA Adverse Event Malfunction Summary report: N

BLADDER CATHETER,NELAT.-ROB.,SIZ.10

MDR report key: 9192070 · Received October 15, 2019

Report

Report Number
9610520-2019-00019
Event Type
Malfunction
Date Received
October 15, 2019
Date of Event
September 1, 2019
Report Date
September 20, 2019
Manufacturer
TELEFLEX MEDICAL
Product Code
KOD
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
RISK MANAGER

Narratives

Additional Manufacturer Narrative · 0

(B)(4). EACH OF THE 5 COMPLAINTS IS REGARDING 1 BLADDER CATHETER, NELATON- OBINSON, P/N 220500 WHERE THE CUSTOMER REPORTED THAT THE CATHETER LEAKED AT THE FUNNEL DURING USE. FOR THE 5 COMPLAINTS (B)(4) ALL IN ALL 3 ACTUAL DEVICES AND 1 REPRESENTATIVE SAMPLE FROM THE SAME LOT WERE RETURNED FOR INVESTIGATION. A LEAK TEST WAS PERFORMED ON THE 3 ACTUAL SAMPLES BY CONNECTING A 1.5 L URINE BAG FILLED WITH WATER TO THE CATHETER. THE FUNCTIONAL TEST CONFIRMED FOR THE 3 SAMPLES A LEAK BETWEEN CATHETER TUBE AND FUNNEL. FURTHERMORE, A FUNCTIONAL INVESTIGATION OF THE REPRESENTATIVE DEVICE WAS CONDUCTED ACCORDING TO THE EFFECTIVE WORK INSTRUCTION FOR THE TIGHTNESS TEST BETWEEN FUNNEL AND TUBE. THE REPRESENTATIVE SAMPLE SHOWED NO LEAK AT THE ADHESIVE CONNECTION BETWEEN TUBE AND FUNNEL. A REVIEW OF THE MANUFACTURING DATA FOR LOT 18/28/212 WAS CARRIED OUT AND NO ISSUES THAT COULD HAVE CONTRIBUTED TO THE REPORTED EVENT WERE IDENTIFIED. THE PERFORMED IN-PROCESS-CONTROLS TO WHICH ALSO A LEAK TEST BELONGS, SHOWED NO DEVIATIONS. FOR INVESTIGATION A NC HAS BEEN OPENED. THE EXAMINATION CONFIRMED THE REPORTED ISSUE FOR THE 3 ACTUAL SAMPLES. HOWEVER, IN THE ROOT CAUSE ANALYSIS, NO CLEAR CAUSE FOR THE FAILURE COULD BE DETERMINED. THE NC ALSO INCLUDES 3 FORMER CONFIRMED COMPLAINTS (TC#: (B)(4)) WITH THE FAILURE "LEAK BETWEEN FUNNEL AND TUBE" FOR THE REPORTED LOT 18/12/212. THE REPORTED SLIGHT LEAKAGE BETWEEN FUNNEL AND CATHETER TUBE OCCURS SPORADICALLY, WHICH IS AN INCONVENIENCE FOR THE USER AND MEANS NO USER RISK.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE CATHETER LEAKED AT THE FUNNEL DURING USE.

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE HAS NOT BEEN RETURNED FOR INVESTIGATION. TELEFLEX WILL CONTINUE TO MONITOR AND TREND RELATED EVENTS.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE CATHETER LEAKED AT THE FUNNEL DURING USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
984005 BLADDER CATHETER,NELAT.-ROB.,SIZ.10 KOD TELEFLEX MEDICAL 18/28/212

Patients

Seq Age Sex Outcome Treatment
1 N/A.