FDA Adverse Event Malfunction Summary report: N

COULTER LH 750 HEMATOLOGY ANALYZER

MDR report key: 2444080 · Received February 9, 2012

Report

Report Number
1061932-2012-00316
Event Type
Malfunction
Date Received
February 9, 2012
Date of Event
January 14, 2012
Report Date
January 14, 2012
Manufacturer
BECKMAN COULTER, INC.
Product Code
GKZ
PMA / PMN Number
K011342
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

CUSTOMER REPORTED TO BECKMAN COULTER, INC. (BEC) THAT THERE WAS A LEAK UNDER THE COULTER LH 750 HEMATOLOGY ANALYZER. CUSTOMER REPORTED THAT PATIENT RESULTS WERE NOT AFFECTED. THERE WAS NO REPORT OF ANY ADVERSE EVENT OR INJURY REQUIRING MEDICAL INTERVENTION OR PATIENT TREATMENT. BEC FIELD SERVICE ENGINEER (FSE) FOUND A HOLE AT THE TUBING THROUGH FEED THROUGH FITTINGS FF79, FF80 AND FF82 OF THE INSTRUMENT. THE FSE REPLACED THE TUBING THROUGH THE FITTINGS AND VERIFIED THE REPAIRS WERE PERFORMED PER ESTABLISHED PROCEDURES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COULTER LH 750 HEMATOLOGY ANALYZER COUNTER, DIFFERENTIAL CELL GKZ BECKMAN COULTER, INC. LH 750 NA

Patients

Seq Age Sex Outcome Treatment
1