FDA Adverse Event Malfunction Summary report: N

ACCESS WASH BUFFER II SOLUTION

MDR report key: 2296375 · Received October 14, 2011

Report

Report Number
2122870-2011-04476
Event Type
Malfunction
Date Received
October 14, 2011
Date of Event
September 20, 2011
Report Date
September 20, 2011
Manufacturer
BECKMAN COULTER, INC.
Product Code
LDT
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SERVICE WAS NOT DISPATCHED TO THE SITE FOR THIS EVENT. BECKMAN COULTER INC. ASSESSMENT OF THE CUSTOMER SUPPLIED PHOTOS INDICATED THAT THERE WAS NO VISIBLE SHIPPING DAMAGE ON THE BOX CONTAINING THE LEAKING BOTTLE. A DEFINITIVE ROOT CAUSE FOR THIS EVENT HAS NOT BEEN DETERMINED TO DATE.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT ON (B)(6) 2011 ONE LEAKING BOTTLE OF ACCESS WASH BUFFER II WAS IDENTIFIED IN A BOX CONTAINING FOUR BOTTLES. THE ISSUE WAS IDENTIFIED IN THE CUSTOMER'S RECEIVING WAREHOUSE. IT IS UNKNOWN AS TO WHETHER PERSONNEL HANDLING THE BOX HOUSING THE LEAKING BOTTLE WERE WEARING PERSONAL PROTECTIVE EQUIPMENT HOWEVER, THERE WAS NO REPORT OF ANY PERSONNEL SEEKING MEDICAL ATTENTION ASSOCIATED WITH THIS EVENT. THE AMOUNT OF LEAKAGE FOR THIS EVENT COULD NOT BE DETERMINED. ALTHOUGH THE FLUID VOLUME OF AN ACCESS WASH BUFFER II BOTTLE IS THEORETICALLY SIGNIFICANT ENOUGH TO CAUSE A SLIPPING HAZARD IF IT IS SPILLED, THERE WERE NO REPORTS OF DEATH, SERIOUS INJURY OR MODIFICATION TO PATIENT TREATMENT ASSOCIATED WITH THIS EVENT. THE FACILITY POSSESSES A HAZARDOUS EXPOSURE PLAN AND THE MATERIAL SAFETY DATA SHEET WAS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACCESS WASH BUFFER II SOLUTION REAGENT, GENERAL PURPOSE LDT BECKMAN COULTER, INC. NA 331826F

Patients

Seq Age Sex Outcome Treatment
1