FDA Adverse Event Malfunction Summary report: N

CX GLUCOSE REAGENT

MDR report key: 2438830 · Received February 3, 2012

Report

Report Number
2050012-2012-00361
Event Type
Malfunction
Date Received
February 3, 2012
Date of Event
January 18, 2012
Report Date
January 18, 2012
Manufacturer
BECKMAN COULTER, INC.
Product Code
CKA
PMA / PMN Number
K883181
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

ON (B)(4) 2012, CUSTOMER REPORTED THAT SHE RECEIVED A GLUCOSE REAGENT CARTRIDGE THAT HAD LEAKED DUE TO A LOOSE CAP. NO EXPOSURE OR INJURIES WERE REPORTED AND NO ERRONEOUS PATIENT RESULTS WERE GENERATED. BECKMAN COULTER SENT A REPLACEMENT CARTRIDGE TO THE CUSTOMER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CX GLUCOSE REAGENT HEXOKINASE, GLUCOSE CKA BECKMAN COULTER, INC. M110253

Patients

Seq Age Sex Outcome Treatment
1