COULTER 4C-ES CELL CONTROL, NORMAL 7547202

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01,05,07 report with the FDA on 2011-10-21 for COULTER 4C-ES CELL CONTROL, NORMAL 7547202 manufactured by Beckman Coulter, Inc..

Event Text Entries

[2223881] A company representative from the beckman coulter, inc. Warehouse in (b)(4) had contacted beckman coulter, inc. (bec) to report observing blood adhered to the packaging of a coulter 4c-es cell control, normal during incoming qc inspection. A digital photograph provided by the company representative revealed a small spot of blood on the inner plastic tray of the packaging. The company representative 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 company representative reported that the facility has a risk management plan in place. The material safety data sheet (msds) was reviewed.
Patient Sequence No: 1, Text Type: D, B5


[9378264] 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 product was not returned for evaluation. The root cause 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 Number1061932-2011-01905
MDR Report Key2326262
Report Source01,05,07
Date Received2011-10-21
Date of Report2010-05-26
Date of Event2010-05-26
Date Mfgr Received2010-05-26
Date Added to Maude2012-07-09
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 4C-ES CELL CONTROL, NORMAL
Product CodeJPK
Date Received2011-10-21
Model NumberNA
Catalog Number7547202
Lot Number1004111F
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
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 2011-10-21

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