FDA Adverse Event Malfunction Summary report: N

COULTER LH 780 HEMATOLOGY ANALYZER

MDR report key: 3882394 · Received June 18, 2014

Report

Report Number
1061932-2014-01379
Event Type
Malfunction
Date Received
June 18, 2014
Date of Event
May 21, 2014
Report Date
May 21, 2014
Manufacturer
BECKMAN COULTER
Product Code
GKZ
PMA / PMN Number
K061616
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

A BECKMAN COULTER (BEC) FIELD SERVICE ENGINEER (FSE) WAS DISPATCHED TO ASSESS THE INSTRUMENT. THE FSE OBSERVED A LEAK DUE TO THE QUICK DISCONNECTS ON THE TUBING THROUGH PINCH VALVES VL46B AND VL41 WERE LOOSE. THE FSE TIGHTENED THE QUICK DISCONNECTS AND THE INSTRUMENT RAN WITHOUT ANY LEAKS. THE FSE VERIFIED THE INSTRUMENT AND THE INSTRUMENT WAS RETURNED TO NORMAL OPERATION. (B)(4).

Description of Event or Problem · 1

THE CUSTOMER REPORTED APPROXIMATELY HALF A CUP OF CLEAR FLUID LEAKED INSIDE THE COULTER LH 780 HEMATOLOGY ANALYZER. THE LEAK WAS NOT CONTAINED WITHIN THE INSTRUMENT. THE CUSTOMER WAS WEARING PERSONAL PROTECTIVE EQUIPMENT (PPE) CONSISTING OF GLOVES AT THE TIME OF THE OCCURRENCE. THERE WAS NO EXPOSURE TO OPEN WOUNDS OR MUCOUS MEMBRANES. NO ERRONEOUS PATIENT RESULTS WERE GENERATED IN CONNECTION WITH THIS EVENT. THERE WAS NO DEATH, INJURY, OR AFFECT TO USER OR TO PATIENT TREATMENT ATTRIBUTED TO THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
356870 COULTER LH 780 HEMATOLOGY ANALYZER COUNTER, DIFFERENTIAL CELL GKZ BECKMAN COULTER NA NA

Patients

Seq Age Sex Outcome Treatment
1