MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2014-08-28 for STATSPIN MP X00-003917-001 manufactured by Iris International.
[4758249]
Customer reported a rotor breakage.
Patient Sequence No: 1, Text Type: D, B5
[12198080]
A loud noise and rotor breakage was reported by the centrifuge. An infant pt sample was lost as a result leading to recollection of sample. It was reported that this delayed pt treatment; however, it is unk if there was any harm to the pt due to the delay. The pieces of rotor and pt sample were contained within the centrifuge and no injuries to user were reported.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 2023446-2014-00137 |
| MDR Report Key | 4102691 |
| Report Source | 05,06 |
| Date Received | 2014-08-28 |
| Date of Report | 2013-07-29 |
| Date of Event | 2014-07-29 |
| Date Mfgr Received | 2014-07-29 |
| Device Manufacturer Date | 2008-10-01 |
| Date Added to Maude | 2014-09-26 |
| 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 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | SUDHA GUPTA |
| Manufacturer Street | 9172 ETON AVE. |
| Manufacturer City | CHATSWORTH CA 91311 |
| Manufacturer Country | US |
| Manufacturer Postal | 91311 |
| Manufacturer Phone | 8185277272 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | STATSPIN MP |
| Generic Name | STATSPIN CENTRIFUGE |
| Product Code | GKG |
| Date Received | 2014-08-28 |
| Catalog Number | X00-003917-001 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | IRIS INTERNATIONAL |
| Manufacturer Address | 9172 ETON AVE. CHATSWORTH CA 91311 US 91311 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2014-08-28 |