MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2011-09-30 for COULTER 4C PLUS CELL CONTROL TRI-PACK 7547114 manufactured by Beckman Coulter, Inc..
[2283233]
The customer had contacted beckman coulter, inc. (bec) to report that a vial of high level control of coulter 4c plus cell control tri-pack was accidently dropped when removing it from their coulter ac-t diff 2 analyzer. The customer reported that the vial had shattered when it hit the floor spilling the contents of the vial onto the floor. The customer reported that approximately 2. 5 ml of the high level control spilled. The customer was wearing personal protective equipment (i. E. , lab coat, gloves, and eye protection) at the time of the event. There was no exposure to mucous membranes or open lesions. There was no report of death or serious injury associated with this event. Medical attention was not sought. The customer cleaned up the spill following their internal biohazardous spill procedure. There is a risk management plan in place for the laboratory. Bec faxed the material safety data sheet (msds) to the customer for review.
Patient Sequence No: 1, Text Type: D, B5
[9308874]
Product labeling states: "beckman coulter, inc. Urges its customers to comply with all national health and safety standards such as the use of barrier protection. This may include, but is not limited to, protective eyewear, gloves, and suitable laboratory attire when operating or maintaining this or any other automated laboratory analyzer. " service was not dispatched for this event. Product was not returned for evaluation (vial shattered after being dropped on the floor). The root cause for this event is attributable to operator error. Product labeling contains sufficient warnings/precautions addressing potential biohazard events. This reportable event was identified during a retrospective review conducted between (b)(4) 2008 and (b)(4) 2010 of complaints for additional reportable events.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 1061932-2011-01593 |
| MDR Report Key | 2281677 |
| Report Source | 05,06 |
| Date Received | 2011-09-30 |
| Date of Report | 2009-06-16 |
| Date of Event | 2009-06-16 |
| Date Mfgr Received | 2009-06-16 |
| Date Added to Maude | 2012-06-28 |
| 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 | 3 |
| 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 CA 92821 |
| Manufacturer Country | US |
| Manufacturer Postal | 92821 |
| Manufacturer Phone | 7149613634 |
| Manufacturer G1 | BECKMAN COULTER, INC. |
| Manufacturer Street | 11800 SW 147TH AVE. |
| Manufacturer City | MIAMI FL 33196 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 33196 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | COULTER 4C PLUS CELL CONTROL TRI-PACK |
| Product Code | JPK |
| Date Received | 2011-09-30 |
| Model Number | NA |
| Catalog Number | 7547114 |
| Lot Number | 084100 |
| ID Number | NA |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BECKMAN COULTER, INC. |
| Manufacturer Address | 11800 SW 147TH AVE. MIAMI FL 33196 US 33196 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2011-09-30 |