COULTER 5C CELL CONTROL 7547001

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2011-07-01 for COULTER 5C CELL CONTROL 7547001 manufactured by Beckman Coulter, Inc..

Event Text Entries

[21364357] Customer reported a potential biohazard event when using the coulter 5c cell control. The abnormal ii vial in the kit was exhibiting a slow drip when inverted. The operator was wearing personal protective equipment at the time of the incident. There was no exposure to mucous membranes or open lesions. No reports of death or serious injury, and no affect to operator safety as a result of this event. This event represents event 2 of 2 events reported by this customer for the second of two lots.
Patient Sequence No: 1, Text Type: D, B5


[21519903] The other two control levels within the kit did not exhibit this issue. Product labeling states: this specimen/reagent should be handled at biosafety level 2, as recommended for any potentially infectious human serum or blood specimen in the centers for disease control/national institutes of health manual "biosafety in microbiological and biomedical laboratories," 1988. " a customer return was not available for eval for this lot. Another lot used by the same customer was evaluated. A small hole was identified in the stopper of the vial which could permit liquid to leak. On (b)(4) 2008, the field service engineer evaluated the coulter maxm w/autoloader (including needle alignment). The analyzer met published performance specifications and did not require any adjustment. Root cause was determined to be user error. This reportable event was identified during a retrospective review conducted between (b)(4) 2008 and (b)(4) 2010 of complaints for additional reportable events. This mdr represents event 2 of 2 reported by this customer. This mdr is related to the following mdrs that have been reported: mdr 1061932-2011-00748.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1061932-2011-00761
MDR Report Key2171221
Report Source05,06
Date Received2011-07-01
Date of Report2008-03-06
Date of Event2008-03-06
Date Mfgr Received2008-03-06
Device Manufacturer Date2008-02-04
Date Added to Maude2012-05-04
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 BLVD
Manufacturer CityBREA CA 92821
Manufacturer CountryUS
Manufacturer Postal92821
Manufacturer Phone7149613634
Manufacturer G1BECKMAN COULTER, INC.
Manufacturer Street11800 SW 147TH AVE
Manufacturer CityMIAMI FL 33196
Manufacturer CountryUS
Manufacturer Postal Code33196
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameCOULTER 5C CELL CONTROL
Product CodeJPK
Date Received2011-07-01
Model NumberNA
Catalog Number7547001
Lot Number1028053K
ID NumberNA
Device Expiration Date2008-04-06
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerBECKMAN COULTER, INC.
Manufacturer Address11800 SW 147TH AVE MIAMI FL 33196 US 33196


Patients

Patient NumberTreatmentOutcomeDate
10 2011-07-01

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