A.T 5DIFF WBC LYSE 8547170

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 2011-08-12 for A.T 5DIFF WBC LYSE 8547170 manufactured by Beckman Coulter, Inc..

Event Text Entries

[2245037] Customer reported a potential chemical exposure when a shipment of a. T 5 diff wbc lyse reagent was received leaking. The shipping container was not damaged. The operators were not exposed to the a. T 5diff wbc lyse reagent. There was no exposure to open lesions, mucus membranes, or any contact to eyes or skin. The operator was wearing proper personal protective equipment of lab coat and gloves. No one sought medical attention and the product material safety data sheet was reviewed. No reports of death or serious injury, and no affect to operator safety as a result of this event.
Patient Sequence No: 1, Text Type: D, B5


[9405000] The leaking bottles of a. T 5diff wbc lyse were discarded by the customer. The product was replaced for the customer. Root cause is unk. The supplier was notified during a retrospective review conducted between january 1, 2008 and october 23, 2010 of complaints for add'l reportable events.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1061932-2011-01138
MDR Report Key2229255
Report Source05,06
Date Received2011-08-12
Date of Report2010-03-29
Date of Event2010-03-17
Date Mfgr Received2010-03-29
Date Added to Maude2012-06-20
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
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 NameA.T 5DIFF WBC LYSE
Product CodeGGK
Date Received2011-08-12
Model NumberNA
Catalog Number8547170
Lot NumberNI
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerBECKMAN COULTER, INC.
Manufacturer Address11800 SW 147TH AVE. MIAMI FL 33196 US 33196


Patients

Patient NumberTreatmentOutcomeDate
10 2011-08-12

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