FDA Adverse Event Other Summary report: N

TRIMA ACCEL PLT, PLS, RBC RAS SET

MDR report key: 2120485 · Received May 27, 2011

Report

Report Number
1722028-2011-00138
Event Type
Other
Date Received
May 27, 2011
Date of Event
January 25, 2011
Report Date
May 2, 2011
Manufacturer
CARIDIANBCT
Product Code
LKN
PMA / PMN Number
BK100032
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4). INVESTIGATION EVAL AND CORRECTIVE ACTIONS ARE IN-PROCESS. A FOLLOW-UP REPORT WILL BE FILED.

Description of Event or Problem · 1

THE CUSTOMER REPORTED POST-COLLECTION HEMOLYSIS THAT EXCEEDED THE (B)(6) REQUIREMENT OF LESS OR EQUAL TO (B)(4). THE DISPOSABLE SET IS NOT AVAILABLE TO BE RETURNED FOR INVESTIGATION. PATIENT AGE IS NOT AVAILABLE AT THIS TIME. THIS REPORT IS BEING FILED DUE TO THE SAFETY ALLEGATION OF HEMOLYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TRIMA ACCEL PLT, PLS, RBC RAS SET SEPARATOR, AUTOMATED, BLOOD CELL AND PL LKN CARIDIANBCT TD1046

Patients

Seq Age Sex Outcome Treatment
1 Other