COULTER RETIC-C CELL CONTROL 7547125

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 2011-10-07 for COULTER RETIC-C CELL CONTROL 7547125 manufactured by Beckman Coulter, Inc..

Event Text Entries

[15577006] The customer had contacted beckman coulter, inc. (bec) to report that one (1) vial of their coulter retic-c cell control leaked from the needle hole in the cap. There was no impact to patient sample results or patient treatment. The customer was wearing protective equipment (i. E. , lab coat and gloves) 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. It is unknown if the customer has a risk management plan in place for the laboratory. It is unknown if the customer reviewed the material safety data sheet (msds).
Patient Sequence No: 1, Text Type: D, B5


[15870704] The root cause for the leak was not determined. 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


MAUDE Entry Details

Report Number1061932-2011-01653
MDR Report Key2320059
Report Source01,05,06
Date Received2011-10-07
Date of Report2009-06-26
Date of Event2009-06-18
Date Mfgr Received2009-06-26
Date Added to Maude2012-06-29
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 NameCOULTER RETIC-C CELL CONTROL
Product CodeJPK
Date Received2011-10-07
Model NumberNA
Catalog Number7547125
Lot Number315302
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerBECKMAN COULTER, INC.
Manufacturer Address11800 SW 147TH AVE. MIAMI FL 33196 US 33196


Patients

Patient NumberTreatmentOutcomeDate
10 2011-10-07

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