FDA Adverse Event Malfunction Summary report: N

SYSMEX SA-10

MDR report key: 6665599 · Received June 23, 2017

Report

Report Number
1000515253-2017-00027
Event Type
Malfunction
Date Received
June 23, 2017
Date of Event
March 17, 2017
Report Date
June 23, 2017
Manufacturer
SYSMEX RA CO. LTD.
Product Code
JRO
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MY
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION BY SYSMEX CORPORATION IN (B)(4) DETERMINED LIGHTNING CAUSED AN EXCESSIVE VOLTAGE THAT EXCEEDED THE PRODUCT STANDARD TO BE APPLIED TO THE POWER SUPPLY UNIT. THE SURGE ABSORBER OF THE BOARD WAS DAMAGED. THERE WAS NO ABNORMALITY FOUND IN THE MANUFACTURING OF THE PRODUCT. THE BOARD WAS REPLACED AND THE INSTRUMENT WAS OPERATIONAL. ANY INCIDENT WITH EXCESSIVE HEAT HAS THE POTENTIAL TO CAUSE USER HARM. THE PCB IS MADE OF FLAME RESISTANT MATERIALS AND COVERED WITH A METAL SHIELD, BUT EXCESSIVE HEAT FROM THE EVENT POSES A RISK OF INHALATION OF SMOKE AND/OR HARMFUL VAPORS FROM MELTED MATERIALS. THE PCB IS NOT ACCESSIBLE TO THE USER, AND IS GROUNDED, REDUCING THE POTENTIAL FOR HARM DUE TO SHOCK.

Description of Event or Problem · 1

THE USER REPORTED A POWER OUTAGE OCCURRED OVER A WEEKEND WHEN THE LABORATORY WAS CLOSED. WHEN THE USER TURNED ON THE ANALYZER MONDAY MORNING, THE SAMPLER WAS NOT FUNCTIONING. A SYSMEX FIELD SERVICE ENGINEER (FSE) WENT ON SITE AND FOUND THE SURGE ABSORBER ON THE PRINTED CIRCUIT BOARD (PCB) POWER SUPPLY WAS CHARRED DUE TO EXCESSIVE HEAT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
443575 SYSMEX SA-10 SA-10 SAMPLER UNIT JRO SYSMEX RA CO. LTD. SA-10

Patients

Seq Age Sex Outcome Treatment
1