inforMED
MalfunctionGGK

COULTER ACT 5 DIFF WBC LYSE

Received Sep 17, 2014 · Event occurred Aug 21, 2014

Report 1061932-2014-02354 · MDR key 4097384

Device

Generic name

Products, Red-cell Lysing Products

Manufacturer

Beckman Coulter

Model number

NA

Catalog number

8547170

Lot number

19002B

Product problems

  • High Test Results
  • Device Contamination with Chemical or Other Material

Patient

Not reported

  • No Known Impact Or Consequence To Patient

Narrative

Description of Event or Problem

THE CUSTOMER REPORTED HIGH CV (COEFFICIENT OF VARIATION) WAS OBTAINED FOR THE WHITE BLOOD CELL (WBC) PARAMETER WHEN USING THE COULTER ACT 5 DIFF CAP PIERCE (CP). THE CUSTOMER PERFORMED TROUBLESHOOTING BY COMPLETING EXTENDED CLEANING. THE PROBLEM WAS NOT RESOLVED AND A BECKMAN COULTER FIELD SERVICE ENGINEER (FSE) WAS SENT TO THE CUSTOMER'S FACILITY TO EVALUATE THE ANALYZER. THE FSE IDENTIFIED CRYSTALS / PRECIPITATE / PARTICLES IN THE ACT 5DIFF WBC LYSE REAGENT. THERE WAS NO REPORT OF ERRONEOUS TEST RESULTS REPORTED OUT OF THE LABORATORY FOR THIS EVENT. THERE WAS NO DEATH, INJURY OR AFFECT TO USER OR PATIENT TREATMENT.

Additional Manufacturer Narrative

ON (B)(4) 2014, THE FIELD SERVICE ENGINEER (FSE) EVALUATED THE INSTRUMENT AND IDENTIFIED THE ACT5DIFF WBC LYSE REAGENT SHOWED CRYSTAL PARTICLES. THE FSE FLUSHED THE SYSTEM AND INSTALLED A FRESH BOTTLE OF WBC LYSE REAGENT AND VERIFIED IT WAS CLEAR OF ANY PRECIPITATE. THE FSE PERFORMED VERIFICATION AND VALIDATION, ALL WITHIN SPECIFICATION. (B)(4).