URO180816

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,user faci report with the FDA on 2019-05-01 for URO180816 manufactured by Medline Industries Inc..

Event Text Entries

[143701882] It was reported that the foley catheter broke off and had to be surgically removed. Despite multiple good faith efforts to obtain additional information, the customer contact was unable or unwilling to provide further patient, product, or incident details to the manufacturer. The sample was received in used, unpackaged condition. The reported issue of a broken foley catheter was confirmed through visual inspection of the received sample, through the presence of a cut across the shaft and a tear in the balloon. There is no definitive root cause for the tears at this time. However, based on the appearance of the received sample, it is suspected that an external force punctured the silicone material, leading to the observed tears. Due to the reported incident and in an abundance of caution, this medwatch is being filed. If any further relevant information is identified or obtained, a supplemental medwatch will be submitted.
Patient Sequence No: 1, Text Type: N, H10


[143701883] It was reported that the foley catheter broke off and had to be surgically removed.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1417592-2019-00062
MDR Report Key8569166
Report SourceHEALTH PROFESSIONAL,USER FACI
Date Received2019-05-01
Date of Report2019-05-01
Date of Event2019-04-04
Date Mfgr Received2019-04-05
Date Added to Maude2019-05-01
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 ContactKAREN TRUTSCH
Manufacturer StreetTHREE LAKES DRIVE
Manufacturer CityNORTHFIELD IL 60093
Manufacturer CountryUS
Manufacturer Postal60093
Manufacturer Phone8476434960
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Generic NameTTLVENT 16FR10ML 100%SIL UM TR
Product CodeOHR
Date Received2019-05-01
Returned To Mfg2019-04-09
Catalog NumberURO180816
Lot NumberUNK
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerMEDLINE INDUSTRIES INC.
Manufacturer AddressTHREE LAKES DRIVE NORTHFIELD IL 60093 US 60093


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2019-05-01

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