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Adverse Event Report

BAXTER HEALTHCARE S.A. BAXTER IMMUNOTHERAPY CRYOCYTE FREEZING CONTAINER   back to search results
Model Number 4R9953
Event Type  Malfunction  
Event Description

Reportedly, the tubing on one cryocyte freezing container broke from the bushing during transport from storage tank to transport tank. Cells were discarded at the time of the event. Sufficient back up cells were on hand for transplantation. No adverse pt event reported in association with the breakage. The containers are fragile when frozen and great care must be taken not to mechanically damage the containers when transporting from one area to another. Any contact may have caused the tubing to break while frozen. Containers were disposed of at time of event.

 
Manufacturer Narrative

Baxter healthcare ("baxter") submits the following report, together with any telephone or written reports on the same incident, to the fda pursuant to the provisions of 21 cfr part 803. These reports are based on info received by baxter which baxter may not have had any opportunity to investigate or verify prior to the required reporting date. These reports shall not be construed as an admission by baxter that the product(s) , described herein, are products of its manufacture and are or were defective or dangerous products in any respect, or that any casual relationship exists between these products and any actual or potential injury. In addition, the submission of a report by baxter shall not be construed as an admission that a reportable event has in fact occurred.

 
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Brand NameBAXTER IMMUNOTHERAPY
Type of DeviceCRYOCYTE FREEZING CONTAINER
Baseline Brand NameCRYOCYTE
Baseline Generic NameFREEZING CONTAINER
Baseline Catalogue Number4R9953
Baseline Model Number4R9953
Other Baseline ID Number250 ML WITH LABEL POCKET
Baseline Device FamilyCRYOCYTE
Baseline Device 510(K) NumberK789354
Baseline Device PMA Number
Baseline Shelf Life Information No
Baseline Preamendment? No
Transitional? No
510(K) Exempt? No
Date First Marketed06/14/1978
Manufacturer (Section F)
BAXTER HEALTHCARE S.A.
highway 201
mountain home AK *
Manufacturer (Section D)
BAXTER HEALTHCARE S.A.
highway 201
mountain home AK *
Manufacturer (Section G)
BAXTER HEALTHCARE S.A.
9 parker
irvine CA 92718
Manufacturer Contact
carol mccorkle
1900 n highway 201
mountain home , AR 72653-2497
(501) 424 -5200
Device Event Key91105
MDR Report Key92235
Event Key86737
Report Number6000004-1997-00011
Device Sequence Number1
Product CodeKSR
Report Source Manufacturer
Source Type Foreign,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial
Report Date 05/12/1997
1 Device Was Involved in the Event
1 Patient Was Involved in the Event
Date FDA Received05/15/1997
Is This An Adverse Event Report? No
Is This A Product Problem Report? Yes
Device Operator Health Professional
Device MODEL Number4R9953
Device Catalogue Number4R9953
Device LOT NumberH95K08460
OTHER Device ID NumberCOMPLAINT FILE# 97NL063
Was Device Available For Evaluation? No
Is The Reporter A Health Professional? Yes
Was the Report Sent to FDA? No
Event Location Invalid Data
Date Manufacturer Received04/16/1997
Was Device Evaluated By Manufacturer? Device Not Returned To Manufacturer
Date Device Manufactured11/01/1995
Is The Device Single Use? Yes
Is the Device an Implant? No
Is this an Explanted Device?
Type of Device Usage Initial

Database last updated on January 30, 2009

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