FDA Adverse Event Other Summary report: N

TRIMA ACCEL PLT, PLS, RBC SET

MDR report key: 2210107 · Received August 5, 2011

Report

Report Number
1722028-2011-00264
Event Type
Other
Date Received
August 5, 2011
Date of Event
May 10, 2011
Report Date
July 11, 2011
Manufacturer
CARIDIANBCT
Product Code
LKN
PMA / PMN Number
BK100032
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). INVESTIGATION EVAL AND CORRECTIVE ACTIONS ARE IN-PROCESS. A F/U REPORT WILL BE PROVIDED.

Description of Event or Problem · 1

FIFTEEN MINUTES INTO THE PROCEDURE, THE DONOR RECEIVED A HEMATOMA. THE DONOR WAS RE-VENIPUNCTURED, BUT THE MACHINE ALARMED AFTER TEN MINUTES, SO THE OPERATOR ENDED THE PROCEDURE. PT INFO IS NOT AVAILABLE AT THIS TIME. THE DISPOSABLE IS NOT AVAILABLE TO BE RETURNED FOR EVAL. THIS REPORT IS BEING FILED DUE TO INSUFFICIENT INFO PROVIDED AT THIS TIME TO DETERMINE IF A MALFUNCTION OCCURRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TRIMA ACCEL PLT, PLS, RBC SET AUTOMATED BLOOD CELL SEPARATOR LKN CARIDIANBCT 12S3317

Patients

Seq Age Sex Outcome Treatment
1