FDA Adverse Event Malfunction Summary report: N

COULTER LH 750 SLIDEMAKER

MDR report key: 2626896 · Received June 23, 2012

Report

Report Number
1061932-2012-01959
Event Type
Malfunction
Date Received
June 23, 2012
Date of Event
May 29, 2012
Report Date
May 29, 2012
Manufacturer
BECKMAN COULTER, INC.
Product Code
GKJ
PMA / PMN Number
CLASS I EXEM
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, 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 SOME MOISTURE IN THE TRAY UNDERNEATH THE SHUTTLE OF THE COULTER LH 750 SLIDEMAKER. THERE WAS NO REPORT OF PATIENT RESULTS AFFECTED. THERE WAS NO REPORT OF ANY ADVERSE EVENT OR INJURY REQUIRING MEDICAL INTERVENTION OR PATIENT TREATMENT. BEC FIELD SERVICE ENGINEER (FSE) OBSERVED 5-10 ML OF ISOTON IN THE UNIT. THE FSE FOUND A HOLE IN THE BLACK STRIPE I-BEAM TUBING THROUGH PINCH VALVE VL18. THE FSE REPLACED THE DAMAGED TUBING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COULTER LH 750 SLIDEMAKER SPINNER, SLIDE, AUTOMATED GKJ BECKMAN COULTER, INC. NA NA

Patients

Seq Age Sex Outcome Treatment
1