FDA Adverse Event Malfunction Summary report: N

AVANTI J-HC CENTRIFUGE

MDR report key: 2544067 · Received April 20, 2012

Report

Report Number
2050012-2012-01023
Event Type
Malfunction
Date Received
April 20, 2012
Date of Event
March 29, 2012
Report Date
March 29, 2012
Manufacturer
BECKMAN COULTER, INC.
Product Code
JQC
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IC
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

UPON FURTHER REVIEW, THE REPORTED INCIDENT IS DETERMINED TO BE NOT REPORTABLE. THE INITIAL INCIDENT REPORT WAS INADVERTENTLY FILED TO THE AGENCY.

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

THE AFFILIATE REPORTED THE CUSTOMER ALLEGED APPROXIMATELY FIFTY PERCENT OF THE LINERS USED IN ROTOR JS-5.0 LEAKED A SUBSTANCE INVOLVING AVANTI J-HC CENTRIFUGE. THE CUSTOMER STATED THE MATERIAL AT THE BOTTOM OF THE LINER APPEARED THIN AND BREAKS. A REPLACEMENT FROM ANOTHER BATCH INVENTORY HAS BEEN ORDERED FOR THE CUSTOMER. THERE WAS NO REPORT OF INJURY OR ADVERSE EFFECT ASSOCIATED WITH THIS INCIDENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 AVANTI J-HC CENTRIFUGE CENTRIFUGES (MICRO, ULTRA, REFRIGERATED) FOR CLINICAL USE JQC BECKMAN COULTER, INC. NA NA

Patients

Seq Age Sex Outcome Treatment
1