SYNCHRON CX3 DELTA 467501

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 2012-04-19 for SYNCHRON CX3 DELTA 467501 manufactured by Beckman Coulter, Inc..

Event Text Entries

[2690563] Customer called to report that the synchron cx3 delta generated falsely high carbon dioxide (co2) results on three patient samples. The results were reported out of the laboratory. However, when anion gaps flagged the samples, five of the samples were rerun and three of the reports were amended. There was no death, injury or change to patient treatment attributed to or associated with this complaint. The field service engineer (fse) inspected the instrument and found that certain hardware parts required replacement and maintenance. The fse replaced the co2 measuring electrode and the electrolyte injection cup (eic) drain valve. The fse also cleaned the flowcell. The fse then verified proper instrument performance to ensure that the services performed effectively resolved the instrument issue. Customer has not called back to report any further issues relating to this event.
Patient Sequence No: 1, Text Type: D, B5


[9859621] (b)(4).
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2050012-2012-00994
MDR Report Key2542017
Report Source05,06
Date Received2012-04-19
Date of Report2012-03-22
Date of Event2012-03-22
Date Mfgr Received2012-03-22
Device Manufacturer Date2006-06-27
Date Added to Maude2012-09-12
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. DUNG NGUYEN
Manufacturer Street250 S. KRAEMER BLVD.
Manufacturer CityBREA CA 928216232
Manufacturer CountryUS
Manufacturer Postal928216232
Manufacturer Phone7149614941
Manufacturer G1BECKMAN COULTER, INC.
Manufacturer Street250 S. KRAEMER BLVD.
Manufacturer CityBREA CA 92821623
Manufacturer CountryUS
Manufacturer Postal Code92821 6232
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSYNCHRON CX3 DELTA
Generic NameANALYZER, CHEMISTRY, MICRO, FOR CLINICAL USE
Product CodeJJF
Date Received2012-04-19
Model NumberNA
Catalog Number467501
ID NumberSW VERSION 6.8
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerBECKMAN COULTER, INC.
Manufacturer Address250 S. KRAEMER BLVD. BREA CA 92821623 US 92821 6232


Patients

Patient NumberTreatmentOutcomeDate
10 2012-04-19

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