FDA Adverse Event Malfunction Summary report: N

CELL-DYN RUBY ANALYZER

MDR report key: 2071106 · Received April 27, 2011

Report

Report Number
2919069-2011-00184
Event Type
Malfunction
Date Received
April 27, 2011
Date of Event
April 14, 2011
Report Date
April 14, 2011
Manufacturer
ABBOTT DIAGNOSTICS DIVISION
Product Code
GKZ
PMA / PMN Number
K061667
Removal / Correction Number
2919069-3/15/11-001-C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

(B)(4): AN EXPANDED INVESTIGATION WAS CONDUCTED TO EVALUATE THIS ISSUE. A PRODUCT CORRECTION LETTER AND CUSTOMER REPLY FORM WILL BE SENT TO ALL ACTIVE CELL-DYN SYSTEM CUSTOMERS WHO RECEIVED THE AFFECTED PART NUMBERS. THE PRODUCT CORRECTION LETTER WILL INSTRUCT CUSTOMERS TO RETURN THE CUSTOMER REPLY FORM TO ABBOTT ACKNOWLEDGING THE RECEIPT AND UNDERSTANDING THE ISSUE OR REQUEST ASSISTANCE. THE NON-CONFORMING PARTS WILL BE REPLACED IN THE FIELD THROUGH A FOUR-MONTH MANDATORY TECHNICAL SERVICE BULLETIN (TSB) ISSUED FOR EACH OF THE CELL-DYNS INVOLVED.

Description of Event or Problem · 1

THE CUSTOMER'S CELL-DYN SHEAR VALVE DRIVE ASSEMBLY WAS REPLACED PER (B)(4). NO IMPACT TO PATIENT RESULTS, PATIENT MANAGEMENT OR USER SAFETY WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CELL-DYN RUBY ANALYZER AUTOMATED HEMATOLOGY ANALYZER GKZ ABBOTT DIAGNOSTICS DIVISION

Patients

Seq Age Sex Outcome Treatment
1 SHEAR VALVE DRIVE ASSEMBLY