MAUDE Adverse Event Report: CHARTER MEDICAL, LTD. 30 - 70 ML CELL FREEZE CRYOGENIC STORAGE CONTAINER

Model Number CF-250

Device Problem Material Integrity Problem (2978)

Patient Problem Insufficient Information (4580)

Event Date 07/02/2020

Event Type  malfunction  

Manufacturer Narrative

The complaint sample was not returned for investigation.The user provided a picture, which indicated a potential hole in the film near the top of the bag.

Event Description

A technologist reported a leak from a tear in one corner of the bag.

• Brand Name: 30 - 70 ML CELL FREEZE CRYOGENIC STORAGE CONTAINER
• Type of Device: 30 - 70 ML CELL FREEZE CRYOGENIC STORAGE CONTAINER
• Manufacturer (Section D): CHARTER MEDICAL, LTD.; 3948-a westpoint blvd.; winston salem NC 27103 6770
• Manufacturer (Section G): CHARTER MEDICAL, LTD.; 3948-a westpoint blvd.; winston salem NC 27103 6770
• Manufacturer Contact: charlene grilletto ; 3948-a westpoint blvd.; winston salem, NC 27103-6770 ; 2675173220
• MDR Report Key: 10591223
• MDR Text Key: 209244382
• Report Number: 1066733-2020-00013
• Device Sequence Number: 1
• Product Code: LPZ
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: BK100049
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: distributor,health profession
• Reporter Occupation: Administrator/Supervisor
• Type of Report: Initial
• Report Date: 09/27/2020

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 09/27/2020
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Expiration Date: 03/01/2024
• Device Model Number: CF-250
• Device Catalogue Number: CF-250
• Device Lot Number: 701435
• Was Device Available for Evaluation?: No
• Date Manufacturer Received: 08/31/2020
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 03/10/2020
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Unknown
• Patient Sequence Number: 1
• Patient Age: 60 YR