BARD HEYMAN FOLLOWER COUDE TIP 14 FR., STERILE 021314

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a other,user facility report with the FDA on 2018-05-15 for BARD HEYMAN FOLLOWER COUDE TIP 14 FR., STERILE 021314 manufactured by C.r. Bard, Inc. (covington) -1018233.

Event Text Entries

[108317389] 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.
Patient Sequence No: 1, Text Type: N, H10


[108317390] It was reported that the tip has been very blunt instead of having a smooth tapered end. This has caused significant damage to the urethral tissue. Per additional information from dr. (b)(6). There was no change in the medical management of the patient who has a more traumatic dilation (damage to urethral tissue) except to leave the post-dilation catheter in longer.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1018233-2018-01758
MDR Report Key7516092
Report SourceOTHER,USER FACILITY
Date Received2018-05-15
Date of Report2018-07-05
Date Mfgr Received2018-07-03
Device Manufacturer Date2017-09-29
Date Added to Maude2018-05-15
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 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 Report3

Device Details

Brand NameBARD HEYMAN FOLLOWER COUDE TIP 14 FR., STERILE
Generic NameDILATION CATHETER
Product CodeFBW
Date Received2018-05-15
Returned To Mfg2018-04-24
Model Number021314
Catalog Number021314
Lot NumberMCBW3409
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerC.R. BARD, INC. (COVINGTON) -1018233
Manufacturer Address8195 INDUSTRIAL BLVD COVINGTON GA 30014 US 30014


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2018-05-15

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