FDA Adverse Event Malfunction Summary report: N

SYNCHRON CX(TM)5 CLINICAL ANALYZER

MDR report key: 2173968 · Received July 24, 2011

Report

Report Number
2050012-2011-02989
Event Type
Malfunction
Date Received
July 24, 2011
Date of Event
June 22, 2011
Report Date
June 22, 2011
Manufacturer
BECKMAN COULTER INC
Product Code
JJE
PMA / PMN Number
K881495
Removal / Correction Number
N/A
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE SAMPLES WERE SERUM. PER CUSTOMER, THE QC WAS WITHIN THE LABORATORY ESTABLISHED RANGES PRIOR TO AND AFTER THE EVENT. A BCI FIELD SERVICE ENGINEER (FSE) CLEANED THE FLOW-CELL AND REPLACED THE CARBON BRIDGE. FSE VERIFIED PERFORMANCE.

Description of Event or Problem · 1

A CUSTOMER CONTACTED BECKMAN COULTER INC. (BEC) IN REGARDS ERRONEOUS HIGH SODIUM (NA) RESULTS ON 4 PATIENT SAMPLES GENERATED BY SYNCHRON CX5 DELTA CLINICAL SYSTEM. THE RESULTS WERE NOT REPORTED OUT OF THE LABORATORY. THE SAMPLES WERE REPEATED AND LOWER RESULTS WERE OBTAINED. PATIENT TREATMENT WAS NOT IMPACTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYNCHRON CX(TM)5 CLINICAL ANALYZER DISCRETE PHOTOMETRIC CHEMISTRY ANALYZER FOR CLINICAL USE. JJE BECKMAN COULTER INC CX 5 DELTA N/A

Patients

Seq Age Sex Outcome Treatment
1