FDA Adverse Event Malfunction Summary report: N

SYNCHRON LX I 725 CLINICAL SYSTEM

MDR report key: 2755190 · Received September 23, 2012

Report

Report Number
2050012-2012-01465
Event Type
Malfunction
Date Received
September 23, 2012
Date of Event
August 29, 2012
Report Date
August 29, 2012
Manufacturer
BECKMAN COULTER, INC.
Product Code
CFR
PMA / PMN Number
K023049
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

EVALUATION RESULTS: GLUCOSE MODULE.

Description of Event or Problem · 1

CUSTOMER REPORTED TO BECKMAN COULTER, INC. (BEC) THAT THE SYNCHRON LXI 725 CLINICAL SYSTEM (LXI #1) GENERATED ERRONEOUS GLUCOSE RESULTS. CUSTOMER REPORTED THE ERRONEOUS RESULTS WERE NOT REPORTED OUT OF THE LABORATORY. CUSTOMER REPORTED THEY REPEATED THE SAMPLES ON THE OTHER LX 20 SYSTEM (LXI #2). CUSTOMER REPORTED THE RESULTS GENERATED BY LXI #2 WERE REPORTED OUT OF THE LABORATORY. THERE WAS NO REPORT OF ANY ADVERSE EVENT OR INJURY REQUIRING MEDICAL INTERVENTION OR PATIENT TREATMENT. BEC FIELD SERVICE ENGINEER (FSE) REPLACED THE GLUCOSE MODULAR REAGENT SYRINGE, CLEANED THE GLUCOSE ELECTRODE AND PERFORMED ALIGNMENTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYNCHRON LX I 725 CLINICAL SYSTEM ANALYZER, CHEMISTRY (PHOTOMETRIC, DISCRETE), FOR CLINICAL USE CFR BECKMAN COULTER, INC. NA NA

Patients

Seq Age Sex Outcome Treatment
1 77 YR