FDA Adverse Event Malfunction Summary report: N

SYNCHRON® LX20 PRO CLINICAL SYSTEM

MDR report key: 2123901 · Received June 14, 2011

Report

Report Number
2050012-2011-02288
Event Type
Malfunction
Date Received
June 14, 2011
Date of Event
May 17, 2011
Report Date
May 17, 2011
Manufacturer
BECKMAN COULTER INC.
Product Code
JJE
PMA / PMN Number
K965240
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

A FIELD SERVICE ENGINEER (FSE) REPORTED THAT THE CUSTOMER LOADED SHORT SAMPLE AND PICKED UP SEVERE CLOT WHICH BROKE THE OBSTRUCTION DETECTOR DIAPHRAGM, JAMMED ELECTROLYTE INJECTION CUP (EIC), WASH COLLAR AND PROBE ON MODULAR CHEMISTRIES (MC) SIDE. THE FSE REPLACED PROBE, WASH COLLAR AND MC CLOT DETECTOR. THE FSE ALSO CLEANED EIC BLOCK PORTS AND RUN ALIGNMENTS. THE ISSUE WAS RESOLVED.

Description of Event or Problem · 1

A CUSTOMER CONTACTED BECKMAN COULTER INC. (BCI) AND REPORTED THAT PROBE ON SYNCHRON LX20 PRO CLINICAL SYSTEM WAS LEAKING FROM REAR OF THE PROBE. NO INJURY WAS REPORTED IN CONNECTION WITH THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYNCHRON® LX20 PRO CLINICAL SYSTEM CLINICAL CHEMISTRY ANALYZER JJE BECKMAN COULTER INC. LX20 PRO NA

Patients

Seq Age Sex Outcome Treatment
1