FDA Adverse Event Malfunction Summary report: N

UNICEL DXH 800 COULTER CELLULAR ANALYSIS SYSTEM

MDR report key: 5993550 · Received October 3, 2016

Report

Report Number
1061932-2016-00868
Event Type
Malfunction
Date Received
October 3, 2016
Date of Event
September 15, 2016
Report Date
September 15, 2016
Manufacturer
BECKMAN COULTER
Product Code
GKZ
PMA / PMN Number
K140911
Removal / Correction Number
N/A
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE FIELD SERVICE ENGINEER (FSE) EVALUATED THE INSTRUMENT. THE FSE FOUND THAT VALVE VL161 WAS FAULTY. THE FSE REPLACED THE VALVE, WHICH REPAIRED THE LEAK. THE REPAIRS WERE VERIFIED BY THE FSE. (B)(4).

Description of Event or Problem · 1

THE CUSTOMER REPORTED A BLOODY LEAK FROM THE UNICEL DXH 800 COULTER CELLULAR ANALYSIS SYSTEM. THE VOLUME OF THE LEAK WAS NOT SPECIFIED AND WAS NOT CONTAINED WITHIN THE INSTRUMENT. THE FSE WAS WEARING PERSONAL PROTECTIVE EQUIPMENT (PPE) CONSISTING OF GLOVES, GOGGLES AND A LABORATORY COAT AT THE TIME OF THE EVENT. THERE WAS NO REPORT OF INJURY OR BIOHAZARD EXPOSURE TO OPEN WOUNDS OR MUCOUS MEMBRANES. ERRONEOUS RESULTS WERE NOT GENERATED. THERE WAS NO CHANGE IN PATIENT TREATMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
646990 UNICEL DXH 800 COULTER CELLULAR ANALYSIS SYSTEM COUNTER, DIFFERENTIAL CELL GKZ BECKMAN COULTER N/A N/A

Patients

Seq Age Sex Outcome Treatment
1