BARD DISPOZ-A-BAG LEG BAG UNKNOWN

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-09-20 for BARD DISPOZ-A-BAG LEG BAG UNKNOWN manufactured by Productos Para El Cuidado De La Salud -9611590.

Event Text Entries

[55466644] The device was not returned for evaluation. The lot number is unknown; therefore, the device history record could not be reviewed. The instructions for use states the following: "- visually inspect the product for any imperfections or surface deterioration prior to use. If package is opened or damaged or if any imperfections or surface deterioration is observed, do not use. Important: hang drainage tube in a straight fashion from bedside to drainage bag. " (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. The device was not returned.
Patient Sequence No: 1, Text Type: N, H10


[55466645] It was reported that urine was "sitting in the top of the drainage tubing" and was not flowing into the leg bag.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1018233-2016-01256
MDR Report Key5963024
Date Received2016-09-20
Date of Report2016-08-29
Date Mfgr Received2016-08-29
Date Added to Maude2016-09-20
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactJANNA PARKS
Manufacturer Street8195 INDUSTRIAL BLVD
Manufacturer CityCOVINGTON GA 30014
Manufacturer CountryUS
Manufacturer Postal30014
Manufacturer Phone7707846100
Manufacturer G1PRODUCTOS PARA EL CUIDADO DE LA SALUD -9611590
Manufacturer StreetKM. 7 CARRETERA INTERNACIONAL
Manufacturer CityNOGALES, SONORA 85621
Manufacturer CountryMX
Manufacturer Postal Code85621
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameBARD DISPOZ-A-BAG LEG BAG
Generic NameLEG BAG
Product CodeFAQ
Date Received2016-09-20
Catalog NumberUNKNOWN
Lot NumberUNK
OperatorLAY USER/PATIENT
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerPRODUCTOS PARA EL CUIDADO DE LA SALUD -9611590
Manufacturer AddressKM. 7 CARRETERA INTERNACIONAL NOGALES, SONORA 85621 MX 85621


Patients

Patient NumberTreatmentOutcomeDate
10 2016-09-20

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