SYNCHRON? TRIGLYCERIDE REAGENT 445850

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01,05,06 report with the FDA on 2011-07-08 for SYNCHRON? TRIGLYCERIDE REAGENT 445850 manufactured by Beckman Coulter, Inc..

Event Text Entries

[18615037] A customer contacted beckman coulter inc. (bci) in regards to a leak from synchron triglyceride reagent kit. The customer was wearing ppe. There was no exposure to uncovered wounds or mucous membranes. No injury was reported, and medical attention was not sought. Msds was reviewed and the customer has exposure control plan in the facility. There was no effect to patient or user.
Patient Sequence No: 1, Text Type: D, B5


[18739543] The reagent vial was broken inside the reagent kit box. Replacement kit was sent to the customer.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2050012-2011-02548
MDR Report Key2154474
Report Source01,05,06
Date Received2011-07-08
Date of Report2011-06-10
Date of Event2011-06-10
Date Mfgr Received2011-06-10
Device Manufacturer Date2011-03-29
Date Added to Maude2012-03-23
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 FDA0
Event Location0
Manufacturer ContactMS. NORA ZEROUNIAN
Manufacturer Street250 S. KRAEMER BOULEVARD
Manufacturer CityBREA CA 92821
Manufacturer CountryUS
Manufacturer Postal92821
Manufacturer Phone7149613634
Manufacturer G1BECKMAN COULTER, INC.
Manufacturer Street250 S. KRAEMER BLVD
Manufacturer CityBREA CA 92821
Manufacturer CountryUS
Manufacturer Postal Code92821
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameSYNCHRON? TRIGLYCERIDE REAGENT
Generic NameLIPASE HYDROLYSIS/GLYCEROL KINASE ENZYME, TRIGLYCERIDES
Product CodeCDT
Date Received2011-07-08
Catalog Number445850
Lot NumberT103125
ID NumberNI
Device Expiration Date2012-09-30
OperatorHEALTH PROFESSIONAL
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerBECKMAN COULTER, INC.
Manufacturer Address250 SOUTH KRAEMER BLVD. BREA CA 92821 US 92821


Patients

Patient NumberTreatmentOutcomeDate
10 2011-07-08

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