FDA Adverse Event Malfunction Summary report: N

ACCESS® OSTASE QC KIT

MDR report key: 1971283 · Received January 26, 2011

Report

Report Number
2122870-2011-00144
Event Type
Malfunction
Date Received
January 26, 2011
Date of Event
December 28, 2010
Report Date
December 28, 2010
Manufacturer
BECKMAN COULTER INC.
Product Code
JJX
PMA / PMN Number
K994277
Removal / Correction Number
Z-2605-6-2011
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
HK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4)

Additional Manufacturer Narrative · 1

AN INVESTIGATION OF DAMAGED OSTASE QC VIALS WAS CONDUCTED AT BECKMAN COULTER (B)(4). THE INVESTIGATION DETERMINED THE GLASS VIALS ARE NOT COMPATIBLE TO FREEZING AT -70 DEGREES CELCIUS. A 100% INSPECTION IS CONDUCTED WHEN THE VIAL LABELING PROCESS IS PERFORMED.

Description of Event or Problem · 1

...

Description of Event or Problem · 1

A CUSTOMER CONTACTED BECKMAN COULTER INC (BCI), STATING THAT AN OSTASE QC VIAL WAS DAMAGED CAUSING THE CONTENTS TO LEAK WITHIN THE QC KIT BOX. THERE WAS NO REPORT OF AFFECT TO PATIENTS OR END USERS IN CONNECTION WITH THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACCESS® OSTASE QC KIT SINGLE (SPECIFIED) ANALYTE CONTROLS (ASSAYED AND UNASSAYED) JJX BECKMAN COULTER INC. NA NOT SUPPLIED

Patients

Seq Age Sex Outcome Treatment
1