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 |