BARD DISPOZ-A-BAG LEG BAG UNK

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-11-15 for BARD DISPOZ-A-BAG LEG BAG UNK manufactured by C.r. Bard, Inc. (covington) -1018233.

Event Text Entries

[92986081] The device was not returned for evaluation. The lot number is unknown; therefore, the device history record could not be reviewed. The product family for this leg bag product is unknown. Therefore, bard is unable to determine the associated labeling to review. Although the product family is unknown, the leg bag product ifus are found to be adequate based on past reviews. (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


[92986082] It was reported that the urine would not drain into the leg bag, and the patient experienced an extended bladder. No patient injury reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1018233-2017-05888
MDR Report Key7032548
Date Received2017-11-15
Date of Report2017-11-15
Date Mfgr Received2017-10-24
Date Added to Maude2017-11-15
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationPATIENT
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactAMY GRAVLEY
Manufacturer Street8195 INDUSTRIAL BLVD
Manufacturer CityCOVINGTON GA 30014
Manufacturer CountryUS
Manufacturer Postal30014
Manufacturer Phone7707846100
Manufacturer G1C.R. BARD, INC. (COVINGTON) -1018233
Manufacturer Street8195 INDUSTRIAL BLVD
Manufacturer CityCOVINGTON GA 30014
Manufacturer CountryUS
Manufacturer Postal Code30014
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 Received2017-11-15
Catalog NumberUNK
Lot NumberUNK
OperatorLAY USER/PATIENT
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerC.R. BARD, INC. (COVINGTON) -1018233
Manufacturer Address8195 INDUSTRIAL BLVD COVINGTON GA 30014 US 30014


Patients

Patient NumberTreatmentOutcomeDate
10 2017-11-15

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