GEM CHECK COAG WHOLE BLOOD CONTROL 6260060600

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 2013-12-19 for GEM CHECK COAG WHOLE BLOOD CONTROL 6260060600 manufactured by International Technidyne Corporation.

Event Text Entries

[3985224] Healthcare facility reports end user was injured when using gem check coag whole blood control. Lab assistant sustained a small cut on her finger from a piece of glass that pierced through the control vial. The end user confirmed the protective sleeve was used during the crushing process to activate the control material and she wore gloves at all times. After activating the control, she subsequently removed the vial from the protective sleeve and held the vial to dispense the control material. The end user felt a stick on her finger, and noticed minor bleeding once removing her glove. The lab assistant was immediately evaluated by the hospital physician and the material safety data sheet was provided. No report of serious injury. This event occurred outside of the united states.
Patient Sequence No: 1, Text Type: D, B5


[11656908] The gem check coag control is manufactured for instrumentation laboratory company by (b)(4). (b)(4) has submitted mdr #2250033-2013-00008 to document this incident. Actual device was returned to (b)(4), but not evaluated by instrumentation laboratory co. U. S. Pictures were obtained showing the crack in the vial. The end user was not using the protective sleeve at the time of the injury and control material was expired. Customer stated that they were aware the control had expired, but used it anyway. The protective sleeve is provided as a means to reduce probability of cuts. The instructions for use indicates use of protective sleeve is required when control vials are activated and while dispensing the control material. Each package includes an insert containing a picture demonstrating the preferred technique to use during activation of the vial.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1217183-2013-00017
MDR Report Key3636672
Report Source05,06
Date Received2013-12-19
Date of Report2013-11-22
Date of Event2013-11-20
Date Mfgr Received2013-11-22
Device Manufacturer Date2011-11-01
Date Added to Maude2014-04-07
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 ContactCAROL MARBLE
Manufacturer Street180 HARTWELL ROAD
Manufacturer CityBEDFORD MA 01730
Manufacturer CountryUS
Manufacturer Postal01730
Manufacturer Phone7818614467
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameGEM CHECK COAG WHOLE BLOOD CONTROL
Product CodeGGN
Date Received2013-12-19
Catalog Number6260060600
Lot NumberM1GP3003
Device Expiration Date2012-09-30
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerINTERNATIONAL TECHNIDYNE CORPORATION
Manufacturer AddressEDISON NJ 08820 US 08820


Patients

Patient NumberTreatmentOutcomeDate
10 2013-12-19

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