FDA Adverse Event Malfunction Summary report: N

BECKMAN COULTER LAB AUTOMATION SYSTEM

MDR report key: 2297166 · Received October 14, 2011

Report

Report Number
2050012-2011-06057
Event Type
Malfunction
Date Received
October 14, 2011
Date of Event
September 16, 2011
Report Date
September 16, 2011
Manufacturer
BECKMAN COULTER BIOMEDICAL GMBH
Product Code
JQP
PMA / PMN Number
EXEMPT
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

A FIELD SERVICE ENGINEER (FSE) WENT ON-SITE AND IMPLEMENTED BEC APPROVED LABELS. FSE CHECKED THE CUSTOMER'S STOCK AND INSTRUCTED CUSTOMER TO REMOVE ALL STOCK OF NON-APPROVED LABEL ROLLS (ABOUT 100 LABEL ROLLS). A SERVICE VISIT WAS SCHEDULED TO INSTALL A SECOND BARCODE READER. (B)(4).

Description of Event or Problem · 1

A CUSTOMER CONTACTED BECKMAN COULTER INC. (BEC) REGARDING AN EVENT THAT OCCURRED AS A RESULT OF PRINTING ERRORS CAUSED BY OPERATING THE AUTOMATE 2500 SYSTEM WITH NON BEC APPROVED LABELS. TWO DIFFERENT BARCODE LABELS WERE FOUND ATTACHED TO ONE SECONDARY TUBE. THE SECOND LABEL WAS DIRECTLY ATTACHED OVER THE FIRST LABEL. THE BARCODE LABELS WERE NOT FROM BEC. THE ERROR MESSAGE THAT WAS DISPLAYED BY THE SYSTEM AFTER THE UNSUCCESSFUL ATTEMPT TO APPLY A LABEL TO THE SECONDARY TUBE WAS NOT CORRECTLY FOLLOWED AND THE PRINTER WAS NOT ADEQUATELY INSPECTED. NO INCORRECT RESULTS WERE REPORTED OUTSIDE OF THE LABORATORY SINCE THE LABORATORY STAFF NOTICED THE DOUBLE LABELED TUBE AND PREVENTED IT FROM FURTHER PROCESSING AND CONDUCTED TESTING WITH THE ORIGINAL TUBE (PRIMARY TUBE). THERE WAS NO AFFECT TO PATIENTS WITH REGARD TO THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BECKMAN COULTER LAB AUTOMATION SYSTEM CALCULATOR/DATA PROCESSING MODULE FOR CLINICAL USE JQP BECKMAN COULTER BIOMEDICAL GMBH AUTOMATE 2500 S3I NA

Patients

Seq Age Sex Outcome Treatment
1