MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer,other report with the FDA on 2017-03-31 for BARD DISPOZ-A-BAG LEG BAG WITH FLIP-FLO DRAINAGE VALVE, FABRIC STRAPS, 150732 manufactured by Productos Para El Cuidado De La Salud -9611590.
[71391433]
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. The device was not returned.
Patient Sequence No: 1, Text Type: N, H10
[71391434]
It was reported that the drain bag was leaking from the seams around the drain valve. The patient allegedly experienced a uti that was treated with antibiotics.
Patient Sequence No: 1, Text Type: D, B5
[74722849]
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: "3. Malfunction and adverse events: - catheter kinking, damage, rupture. - difficulty or failure to remove the device. - occlusion of catheter inner lumens. - encrustation. - accidental removal of the device due to leakage of sterile water or balloon rupture. - device damage due to inappropriate use. - failure to measure temperatures. - improper temperature indication. 2) adverse events: - urinary-tract infection. - hemorrhage, hematuria. - allergy reaction to the device. - calculus formation. - edema. - pain. - discomfort. - injury of bladder or urethral. - urethritis, urinary incontinence. - retained balloon fragments. " (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
[74722850]
It was reported that the drain bag was leaking from the seams around the drain valve. The patient allegedly experienced a uti that was treated with antibiotics.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 1018233-2017-01466 |
MDR Report Key | 6449082 |
Report Source | CONSUMER,OTHER |
Date Received | 2017-03-31 |
Date of Report | 2017-05-03 |
Date Mfgr Received | 2017-04-13 |
Date Added to Maude | 2017-03-31 |
Event Key | 0 |
Report Source Code | Manufacturer report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
Reporter Occupation | PATIENT |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
Manufacturer Contact | AMY GRAVLEY |
Manufacturer Street | 8195 INDUSTRIAL BLVD |
Manufacturer City | COVINGTON GA 30014 |
Manufacturer Country | US |
Manufacturer Postal | 30014 |
Manufacturer Phone | 7707846100 |
Manufacturer G1 | PRODUCTOS PARA EL CUIDADO DE LA SALUD -9611590 |
Manufacturer Street | KM. 7 CARRETERA INTERNACIONAL |
Manufacturer City | NOGALES, SONORA 85621 |
Manufacturer Country | MX |
Manufacturer Postal Code | 85621 |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | BARD DISPOZ-A-BAG LEG BAG WITH FLIP-FLO DRAINAGE VALVE, FABRIC STRAPS, |
Generic Name | DRAIN BAG |
Product Code | FAQ |
Date Received | 2017-03-31 |
Catalog Number | 150732 |
Lot Number | UNK |
Operator | HEALTH PROFESSIONAL |
Device Availability | N |
Device Age | DA |
Device Eval'ed by Mfgr | R |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | PRODUCTOS PARA EL CUIDADO DE LA SALUD -9611590 |
Manufacturer Address | KM. 7 CARRETERA INTERNACIONAL NOGALES, SONORA 85621 MX 85621 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Required No Informationntervention | 2017-03-31 |