FDA Adverse Event Injury Summary report: N

BCS(R) XP SYSTEM

MDR report key: 2002638 · Received February 28, 2011

Report

Report Number
9610806-2011-00001
Event Type
Injury
Date Received
February 28, 2011
Date of Event
February 1, 2011
Report Date
February 7, 2011
Manufacturer
SIEMENS HEALTHCARE DIAGNOSTICS PRODUCTS GMBH
Product Code
GJS
PMA / PMN Number
K003870
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AU
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE CAUSE OF THE BROKEN VIAL IS UNKNOWN. NO FURTHER EVALUATION OF THE DEVICE IS POSSIBLE.

Description of Event or Problem · 1

AN OPERATOR WAS PERFORMING STANDARD OPERATIONS WITH THE THROMBOREL S REAGENT VIAL AND A FINGER WAS CUT BY THE GLASS VIAL. THE BOTTOM OF THE VIAL BROKE DURING OPENING. THE OPERATOR RECEIVED MEDICAL ATTENTION IMMEDIATELY AND EVERY TWO DAYS FOR SPECIAL WOUND TREATMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BCS(R) XP SYSTEM THROMBOREL S GJS SIEMENS HEALTHCARE DIAGNOSTICS PRODUCTS GMBH

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention