MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2003-09-16 for ORTHO SUMMIT PROCESSOR 7003015 936480 manufactured by Ortho-clinical Diagnostics.
[331122]
The customer reported that while processing an hbsag microwell plate on osp, the technician reported that a syringe dispensed fluid outside the target well. No error was generated. No death or serious injury was associated with this incident.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2250051-2003-01172 |
| MDR Report Key | 484581 |
| Date Received | 2003-09-16 |
| Date of Report | 2003-09-12 |
| Date of Event | 2003-09-10 |
| Date Facility Aware | 2003-09-10 |
| Report Date | 2003-09-12 |
| Date Added to Maude | 2003-09-25 |
| Event Key | 0 |
| Report Source Code | Distributor report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ORTHO SUMMIT PROCESSOR |
| Generic Name | SAMPLE PROCESSOR |
| Product Code | GKH |
| Date Received | 2003-09-16 |
| Model Number | 7003015 |
| Catalog Number | 936480 |
| Lot Number | NA |
| ID Number | NA |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Age | * |
| Implant Flag | N |
| Date Removed | A |
| Device Sequence No | 1 |
| Device Event Key | 473472 |
| Manufacturer | ORTHO-CLINICAL DIAGNOSTICS |
| Manufacturer Address | 1001 US HWY 202 RARITAN NJ 088690606 US |
| Baseline Brand Name | ORTHO SUMMIT PROCESSOR |
| Baseline Generic Name | SAMPLE PROCESSOR |
| Baseline Model No | 7003015 |
| Baseline Catalog No | 936480 |
| Baseline ID | NA |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2003-09-16 |