BARDIA URINARY DRAIN BAG 802001

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer,other report with the FDA on 2019-11-26 for BARDIA URINARY DRAIN BAG 802001 manufactured by C.r. Bard, Inc. (covington) -1018233.

MAUDE Entry Details

Report Number1018233-2019-07545
MDR Report Key9378105
Report SourceCONSUMER,OTHER
Date Received2019-11-26
Date of Report2019-11-26
Date Mfgr Received2019-11-04
Date Added to Maude2019-11-26
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 ContactYONIC ANDERSON
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 NameBARDIA URINARY DRAIN BAG
Generic NameDRAIN BAG
Product CodeKNX
Date Received2019-11-26
Returned To Mfg2019-11-07
Model Number802001
Catalog Number802001
Lot NumberUNK
OperatorLAY USER/PATIENT
Device AvailabilityR
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. Required No Informationntervention 2019-11-26

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