MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2016-09-28 for CLINIMACS PBS/EDTA BUFFER 1000 ML N/A 700-25 manufactured by Miltenyi Biotec Gmbh.
[55837923]
Patient Sequence No: 1, Text Type: N, H10
[55837924]
The customer reported on a tiny fragment from the port seal that came away into the solution of the clinimacso pbs/edta buffer il bag, ce after spiking with a sample site coupler. The customer wasted the affected buffer bag and used a new one for performing the cell separation. Therefore any risk for patients can be ruled out. The day of the event is not known.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3005290010-2016-00091 |
| MDR Report Key | 5984024 |
| Report Source | COMPANY REPRESENTATIVE |
| Date Received | 2016-09-28 |
| Date of Report | 2016-09-28 |
| Date Mfgr Received | 2016-09-08 |
| Device Manufacturer Date | 2014-09-22 |
| Date Added to Maude | 2016-09-28 |
| 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 | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS NANCY JOHANSEN |
| Manufacturer Street | 85 HAMILTON ST |
| Manufacturer City | CAMBRIDGE MA 02139 |
| Manufacturer Country | US |
| Manufacturer Postal | 02139 |
| Manufacturer Phone | 6172180062 |
| Manufacturer G1 | MILTENYI BIOTEC GMBH |
| Manufacturer Street | FRIEDRICH-EBERT-STRASSE 68 |
| Manufacturer City | BERGISCH GLADBACH, 51429 |
| Manufacturer Country | GM |
| Manufacturer Postal Code | 51429 |
| Single Use | 3 |
| Remedial Action | RL |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | CLINIMACS PBS/EDTA BUFFER 1000 ML |
| Generic Name | CLINIMACS PBS/EDTA BUFFER 1000 ML |
| Product Code | OVG |
| Date Received | 2016-09-28 |
| Model Number | N/A |
| Catalog Number | 700-25 |
| Lot Number | D0517 |
| Device Expiration Date | 2017-08-22 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MILTENYI BIOTEC GMBH |
| Manufacturer Address | FRIEDRICH-EBERT-STRASSE 68 BERGISCH GLADBACH, 51429 GM 51429 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2016-09-28 |