COULTER 5C CELL CONTROL, TRI-PACK 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 2011-09-30 for COULTER 5C CELL CONTROL, TRI-PACK 7547001 manufactured by Beckman Coulter, Inc..

Event Text Entries

[16539299] The customer had contacted beckman coulter, inc. (bec) to report that a vial of their coulter 5c cell control, tri-pack leaked when the vial was taken out of the refrigerator and allowed to warm to room temperature. The customer reported that the top was tight and the pierce location was in the center area. The customer reported observing a blood stain on the counter where the vial was placed to warm up. It is unknown what part of the vial/top was leaking. The customer was wearing personal protective equipment 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 reported that the laboratory has an exposure safety office on-site. The material safety data sheet (msds) was not reviewed.
Patient Sequence No: 1, Text Type: D, B5


[16567360] 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. The estimated leaked volume on the counter was 0. 5 ml. The customer cleaned the counter with bleach and water. The product was not returned for evaluation. The root cause was not determined. Product labeling contains sufficient warnings/precautions addressing potential biohazard events. This mdr represents event 2 of 2 reported by the customer for similar events. This mdr is related to the following mdr that has been reported: mdr #1061932-2011-01586. This reportable event was identified during a retrospective review conducted between (b)(4), 2008 and (b)(4), 2010 of complaints for additional reportable events. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1061932-2011-01589
MDR Report Key2281689
Report Source05,06
Date Received2011-09-30
Date of Report2009-06-02
Date of Event2009-06-02
Date Mfgr Received2009-06-02
Date Added to Maude2012-06-28
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, TRI-PACK
Product CodeJPK
Date Received2011-09-30
Model NumberNA
Catalog Number7547001
Lot Number889400
ID Number876900
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
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 2011-09-30

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