4C PLUS COULTER CELL CONTROL 7547114

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 2011-10-28 for 4C PLUS COULTER CELL CONTROL 7547114 manufactured by Beckman Coulter, Inc..

Event Text Entries

[2226941] The customer reported that after several piercings during use onboard the act diff 2 hematology analyzer, one vial of 4c plus cell control leaked inside its packaging while being stored between use in the refrigerator. The operator was wearing personal protective equipment (lab coat, gloves and eye protection) at the time of the incident and there was no exposure of potentially biohazardous material to mucous membranes or open lesions. The operator did not s eek medical attention.
Patient Sequence No: 1, Text Type: D, B5


[9369996] This reportable event was identified during a retrospective review conducted for the period between (b)(4) 2008 and (b)(4) 2010 of complaints for additional reportable events. Product was replaced at the time of the event. Field service was not dispatched. Based upon available information the root cause of the leaky vial is unknown.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1061932-2011-01998
MDR Report Key2320296
Report Source05,06
Date Received2011-10-28
Date of Report2009-06-16
Date of Event2009-06-16
Date Mfgr Received2009-06-16
Date Added to Maude2011-12-19
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 Name4C PLUS COULTER CELL CONTROL
Product CodeJPK
Date Received2011-10-28
Model NumberNA
Catalog Number7547114
Lot Number1000241K
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
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 2011-10-28

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