MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 00,01 report with the FDA on 2011-06-10 for SYNCHRON URIC ACID 442785 manufactured by Beckman Coulter Inc..
[19709577]
No additional information was provided. Cx/lx iron ferrous kit, catalog number : 467910, lot number: m008562, classification code jiy, 510k: k960485, date of manufacture: 10/12/2010. Cx/lx valproic acid, catalog number : 467995, lot number: m102369, classification code leg, 510k: k961256, date of manufacture: 01/31/2011.
Patient Sequence No: 1, Text Type: N, H10
[19844246]
Beckman coulter inc. (bci) (b)(4) reported cx uric acid reagent, cx/lx iron ferrous, cx/lx valproic acid cartridges leaked and were unable to determine to source of the leak. No injury was reported.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2050012-2011-02258 |
| MDR Report Key | 2120810 |
| Report Source | 00,01 |
| Date Received | 2011-06-10 |
| Date of Report | 2011-05-12 |
| Date of Event | 2011-05-12 |
| Date Mfgr Received | 2011-05-12 |
| Device Manufacturer Date | 2011-03-29 |
| Date Added to Maude | 2012-02-21 |
| 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 KRAEMER BLVD. |
| Manufacturer City | BREA CA 92821 |
| Manufacturer Country | US |
| Manufacturer Postal | 92821 |
| Manufacturer Phone | 7149613634 |
| Manufacturer G1 | BECKMAN COULTER INC. |
| Manufacturer Street | 250 S. KRAEMER BLVD |
| Manufacturer City | BREA CA 92821 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 92821 |
| Single Use | 3 |
| Remedial Action | OT |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | SYNCHRON URIC ACID |
| Generic Name | CX URIC ACID REAGENT |
| Product Code | KNK |
| Date Received | 2011-06-10 |
| Model Number | URIC ACID |
| Catalog Number | 442785 |
| Lot Number | M103154 |
| ID Number | N/A |
| Operator | OTHER |
| Device Availability | Y |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BECKMAN COULTER INC. |
| Manufacturer Address | 250 S. KRAEMER BLVD BREA CA 92821 US 92821 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2011-06-10 |