FDA Adverse Event Malfunction Summary report: N

COULTER® AC*T DIFF 2 ANALYZER

MDR report key: 3200719 · Received July 1, 2013

Report

Report Number
1061932-2013-01268
Event Type
Malfunction
Date Received
July 1, 2013
Date of Event
June 4, 2013
Report Date
June 4, 2013
Manufacturer
BECKMAN COULTER
Product Code
GKZ
PMA / PMN Number
K990352
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

A BECKMAN COULTER FSE (FIELD SERVICE ENGINEER) WAS DISPATCHED AND REPLACED THE PROBE WIPE TO RESOLVE THE ISSUES. REPAIR WAS VERIFIED PER ESTABLISHED PROCEDURES AND RESULTS MET PUBLISHED SPECIFICATIONS. RESULTS: FAILURE MODE OF THE EVENT IS ATTRIBUTED TO THE PROBE WIPE. (B)(4).

Description of Event or Problem · 1

THE CUSTOMER REPORTED HEARING NOISE FROM THE PROBE WHEN RUNNING QC (QUALITY CONTROL) INVOLVING THE COULTER ACT DIFF 2 ANALYZER. THE CUSTOMER ALSO INDICATED THAT THE CP (CAP PIERCE) DOOR WOULD NOT OPEN. THE CUSTOMER DISCOVERED A LEAK FROM THE PROBE ABOVE THE CP MECHANISM DOOR AND THAT THE DOOR WAS WET WITH FLUID. THE CUSTOMER STATED THAT LESS THAN 5 ML OF FLUID LEAKED AND THE LEAK WAS NOT CONTAINED WITHIN THE INSTRUMENT. THE CUSTOMER WAS WEARING GLOVES AND A LABORATORY COAT AT THE TIME OF THE EVENT AND NO INJURY OR EXPOSURE TO MUCOUS MEMBRANE OR OPEN WOUNDS WAS REPORTED. NO ERRONEOUS PATIENT RESULTS WERE GENERATED AND THERE WAS NO CHANGE OR AFFECT TO PATIENT TREATMENT IN CONNECTION WITH THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
297857 COULTER® AC*T DIFF 2 ANALYZER COUNTER, DIFFERENTIAL CELL GKZ BECKMAN COULTER NA NA

Patients

Seq Age Sex Outcome Treatment
1