MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2010-09-13 for NOT APPLICABLE N/A 6605500 manufactured by Beckman Coulter Inc.
[1354158]
A customer contacted beckman coulter inc. (bci) to report a pak reagent was damaged during shipment and leaked. The shipment was rejected upon receipt. The instrument associated with this event is the coulter act differential 2 analyzer. The customer was wearing personal protective equipment (ppe). No death nor injury and no exposure to open lesions or mucous membranes.
Patient Sequence No: 1, Text Type: D, B5
[8749918]
Service was not dispatched replacement was shipped to the customer. A clear root cause can not be determined for this event.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 1061932-2010-00143 |
| MDR Report Key | 1832901 |
| Report Source | 05 |
| Date Received | 2010-09-13 |
| Date of Report | 2010-09-13 |
| Date of Event | 2010-08-17 |
| Date Mfgr Received | 2010-08-17 |
| Date Added to Maude | 2010-12-01 |
| 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 |
| Health Professional | 0 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | MS. NORA ZEROUNIAN |
| Manufacturer Street | 250 S. KRAEMER BLVD. |
| Manufacturer City | BREA 92821 |
| Manufacturer Country | US |
| Manufacturer Postal | 92821 |
| Manufacturer Phone | 7149613634 |
| Manufacturer G1 | BECKMAN COULTER INC. |
| Manufacturer Street | 11800 SW 147TH AVENUE |
| Manufacturer City | MIAMI 33196 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 33196 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | NOT APPLICABLE |
| Generic Name | PAK REAGENT |
| Product Code | MVU |
| Date Received | 2010-09-13 |
| Model Number | N/A |
| Catalog Number | 6605500 |
| Lot Number | N/A |
| Device Availability | Y |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BECKMAN COULTER INC |
| Manufacturer Address | 11800 SW 147TH AVENUE MIAMI 33196 US 33196 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2010-09-13 |