MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2011-12-08 for SYNCHRON SYSTEMS DRUG CALIBRATOR 2 469630 manufactured by Beckman Coulter, Inc..
[2458856]
Customer reported to beckman coulter, inc. (bec) that a kit of synchron systems drug calibrator 2 that he believed he received two to three months ago had leaked in the shipping box during shipment of the kit. Customer indicated that he had already thrown away the kit and thus did not have the lot number. There was no report of erroneous results generated. There was no report of any adverse event or injury requiring medical intervention or patient treatment.
Patient Sequence No: 1, Text Type: D, B5
[9496471]
Synchron systems drug calibrator 2 contains material of human origin and should be considered potentially infectious. (b)(4).
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 2050012-2011-08223 |
| MDR Report Key | 2364020 |
| Report Source | 05,06 |
| Date Received | 2011-12-08 |
| Date of Report | 2011-11-10 |
| Date of Event | 2011-11-10 |
| Date Mfgr Received | 2011-11-10 |
| Date Added to Maude | 2012-07-23 |
| 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. DUNG NGUYEN |
| Manufacturer Street | 250 S. KRAEMER BLVD. |
| Manufacturer City | BREA CA 92821 |
| Manufacturer Country | US |
| Manufacturer Postal | 92821 |
| Manufacturer Phone | 7149613634 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | SYNCHRON SYSTEMS DRUG CALIBRATOR 2 |
| Generic Name | CALIBRATORS, DRUG SPECIFIC |
| Product Code | DLJ |
| Date Received | 2011-12-08 |
| Catalog Number | 469630 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BECKMAN COULTER, INC. |
| Manufacturer Address | 250 S. KRAMER BLVD. BREA CA 92821 US 92821 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2011-12-08 |