VENTANA (a member of the Roche Group) BenchMark ULTRA; REF/MU 750-600; Research Use Only Product Usage: Research Use Only-The DISCOVERY ULTRA Advanced Staining System is intended to automatically stain histological or cytological specimens on microscope slides with specific inununohistochemistry or in situ hybridization reagents.
- Company
- Ventana Medical Systems Inc
- Recall Initiated
- September 28, 2012
- Posted
- August 6, 2013
- Terminated
- February 24, 2016
- Recall Number
- Z-0833-2013
- Quantity
- 1735 instruments
- Firm Location
- Oro Valley, AZ
Reason for Recall
Potiential for a waste fluid overflow condition to accur while running decontamination cycles on the BenchMark ULTRA automated staining platform or the DISCOVERY ULTRA automated staining platform. This type of overflow event can lead to migration of fluid across tubing and wiring within the instrument cabinet resulting in contact with electrical circuitry. This may create shorting conditions and u
Distribution
Worldwide distribution: USA (nationwide) and country of: Germany.
Lot / Code Info
Cat#750-600; PN 05342716001; Serial #'s: 310724, 310735, 311187, 312055, 310373, 311052, 311171, 311953, 310750, 311266, 311267, 311564, 311565, 311596, 311304, 310481, 311924, 310607, 311627, 310527, 311436, 311742, 310132, 311432, 310034, 310408, 310687, 310697, 311343, 311958, 310728, 310778, 311991, 312070, 310471, 311326, 311952, 310103, 310777, 311446, 310924, 311303, 311528, 310490, 310913, 311529, 311494, 310139, 310281, 310465, 310275, 310617, 310665, 310716, 311853, 311871, 312137, 312101, 310240, 310237,310238, 311571, 311404, 310356, 310023, 312164, 312165, 310065, 310231, 310711, 310706, 310707, 310703, 311509, 310330, 310633, 311811, 311810, 310977, 311194, 311198, 310208, 310732, 310740, 310187, 311462, 311935, 310145, 311037, 310346, 310585, 310694, 310699, 310701, 310702, 310705, 310709, 310710, 310704, 311106, 311110, 311111, 311419, 311484, 311527, 310345, 311381, 311353, 310480, 311869, 311921, 311458, 310315, 310412, 311988, 310618, 310397, 310399, 311868, 311919, 312139, 312141, 312142, 311270, 310069, 311466, 311929, 310083, 310094, 310154, 311904, 310588, 312098, 312100, 310814, 311731, 311783, 311785, 312096, 312104, 312153, 310227, 310781, 310174, 311403, 311080, 311081, 311121, 311122, 311169, 311188, 311189, 311190, 311242, 311245, 311298, 311926, 310403, 310718, 311416, 311417, 312105, 312112, 310796, 310832, 310824, 311135, 311248, 312066, 310895, 310267, 310272, 311481, 311771, 311772, 310882, 311186, 311937, 310344, 311439, 311505, 310146, 310506, 311545, 310446, 310312, 311584, 312124, 310839, 311319, 311261, 310070, 310508, 311367, 311578, 311576, 311629, 311601, 311600, 311607, 311603, 311602, 311606, 311598, 311597, 311604, 311605, 311599, 311272, 312145, 312123, 310339, 310455, 310472, 310478, 310482, 311562, 311560, 311923, 311498, 311814, 311813, 311804, 310020, 310844, 311313, 311533, 310779, 311241, 311750, 310268, 310331, 311221, 311036, 311034, 311035, 310201, 310321, 310792, 312056, 311147, 311153, 311315, 311308, 310641, 310678, 310878, 310032, 311774, 311182, 310390, 311151, 311268, 311284, 311552, 310902, 311455, 310491, 311038, 312008, 310282, 310696, 311735, 310173, 310402, 311710, 312118, 311874, 310972, 311375, 311727, 312128, 312134, 310933, 310921, 311285, 310297, 310769, 311876, 310916, 311486, 310460, 310245, 310576, 311483, 312097, 312099, 312089, 312109, 311518, 311479, 311901, 312144, 312172, 311551, 310555, 310363, 311808, 310570, 311001, 310358, 310492, 311252, 311687, 311672, 311402, 310114, 310122, 310126, 311300, 310794, 311350, 311592, 310749, 310285, 311299, 310897, 311323, 310258, 310467, 310470, 311628, 310943, 310035, 310066, 310087, 310185, 310752, 310757, 311134, 312138, 310489, 311973, 311191, 310456, 310575, 310673, 310683, 310890, 310821, 312170, 312171, 312060, 312102, 312202, 310500, 310505, 311394, 311917, 311511, 311530, 310894, 312136, 311369, 311665, 312152, 310804, 311517, 311465, 310893, 310896, 311946, 311947, 310323, 310776, 310654, 310299, 310452, 311675, 310404, 310810, 310708, 310712, 311073, 311250, 310910, 311401, 311928, 310941, 310026, 310089, 310336, 310341, 311736, 311610, 311608, 311609, 311728, 310820, 311821, 310141, 310912, 311443, 311442, 311243, 311207, 310256, 310378, 310229, 312163, 312058, 310771, 311103, 310915, 310533, 310124, 311318, 310218, 310811, 311738, 310037, 310038, 310365, 310377, 311210, 312085, 312086, 312087, 311295, 312023, 311493, 311357, 310833, 310800, 311464, 311423, 311173, 311364, 310135, 310608, 310935, 311352, 311354, 311356, 310920, 310183, 310257, 310306, 310852, 311431, 310876, 311949, 311956, 310828, 310830, 310928, 310929, 310930, 310355, 310271, 311384, 312122, 310846, 311345, 310119, 310391, 310881, 310483, 310488, 311893, 312063, 310284, 311663, 312131, 310374, 310507, 310144, 310775, 311730, 311939, 310106, 310205, 310241, 310620, 310713, 310031, 310742, 311016, 311463, 310445, 312117, 310906, 311376, 311377, 311378, 311379, 311380, 310288, 311334, 311957, 311714, 310898, 311477, 310210, 310224, 311033, 312076, 312078, 312090, 310632, 312116, 310751, 310249, 311468, 310923, 310123, 311760, 310180, 311160, 310905, 310605, 310458, 311925, 310822, 311485, 311503, 311500, 311474, 310879, 312061, 310189, 310191, 312039, 312051, 312052, 312059, 312188, 311948, 311072, 310182, 310503, 310922, 311172, 311461, 311324, 311209, 310799, 310807, 310314, 310855, 312127, 310084, 310165, 311322, 311321, 310573, 310572, 311559, 310375, 310181, 310308, 312103, 312077, 312106, 312107, 312108, 310474, 310486, 312021, 312167, 312169, 311247, 310634, 310461, 312203, 310730, 310729, 311065, 311348, 311346, 311332, 310763, 312126, 310036, 310348, 310362, 311395, 311459, 311472, 311236, 311450, 311451, 310884, 311118, 311887, 311337, 311338, 310842, 310028, 310318, 310479, 311773, 311259, 311679, 312009, 312012, 310283, 310453, 310501, 310663, 310889, 310715, 311482, 311183, 311184, 310610, 311520, 311506, 310369, 310770, 310351, 310827, 310497, 311006, 311399, 311040, 311355, 312132, 312133, 311510, 310410, 312088, 311407, 310043, 310044, 310045, 310818, 310085, 311120, 311918, 311989, 311117, 310179, 311105, 311049, 312176, 310099, 311563, 310100, 310190, 311823, 310058, 310061, 310864, 311389, 310805, 310048, 311911, 311425, 311146, 310228, 310260, 311534, 310736, 310738, 310722, 311223, 310128, 310137, 310059, 312140, 311471, 311519, 310831, 310120, 311307, 310806, 311902, 310319, 311798, 311802, 312129, 312130, 311076, 311139, 311132, 311181, 311496, 311507, 312147, 312154, 310762, 310447, 311168, 310466, 311619, 311617, 310451, 311415, 311756, 312048, 311149, 310892, 311488, 311491, 311238, 311531, 311801, 311898, 311934, 310101, 310142, 311532, 311317, 311341, 310637, 311310, 311237, 310880, 311420, 312053, 311940, 311941, 311951, 311467, 310209, 310817, 311708, 310413, 311755, 310462, 310464, 311927, 311697, 310354, 312057, 311041, 311115, 311492, 311441, 310195, 310125, 310194, 310223, 310222, 310279, 310469, 310795, 310326, 311502, 311192, 311039, 311051, 311385, 310405, 311764, 310850, 311413, 310825, 310743, 310744, 310785, 310801, 310802, 310280, 310303, 311251, 311406, 311200, 311333, 310401, 311271, 310325, 311920, 310793, 310684, 310068, 311262, 311264, 310109, 311161, 311487, 312119, 311834, 311950, 311729, 311437, 311444, 312054, 311053, 311046, 311193, 310649, 310392, 311860, 310409, 312120, 312121, 311104, 311892, 310812, 310996, 310556, 311936, 310739, 311677, 312064, 312065, 312110, 312113, 310883, 311907, 311945, 310639, 311900, 310564, 311522, 311535, 311239, 311240, 310809, 311296, 311843, 311454, 311480, 310476, 312095, 311997, 311820, 310566, 311784, 311258, 310192, 310758, 311818, 311899, 311201, 311382, 310843, 310733, 310734, 311712, 311440, 311150, 310937, 310737, 310680, 310829, 311430, 310609, 310741, 311246, 311253, 311342, 310545, 310568, 311699, 311698, 310939, 310942, 310496, 310907, 311909, 310692, 310926, 310534, 311269, 310838, 310327, 311852, 312111, 310891, 310062, 310172, 310834, 310463, 310502, 310914, 311944, 311021, 310316, 311695, 311703, 311805, 311806, 311807, 311809, 312003,311005, 310885, 311752, 311751, 311732, 312150, 311942, 312026, 310676, 310225, 310353, 310473, 310475, 311508, 310717, 311089, 311148, 311138, 311140, 311141, 311320, 310454, 312143, 310593, 310591, 310657, 312081, 312125, 310226, 310611, 311349, 312151, 310322, 310064, 310748, 310216, 310494, 310495, 311029, 310217, 312016, 311775, 311777, 310443, 310597, 310603, 310602, 310606, 310360, 310130, 310131, 310133, 310143, 311178, 310138, 310140, 310276, 311792, 311504, 311501, 311499, 310411, 310621, 310690, 310727, 311249, 311288, 311400, 311418, 311457, 311470, 311696, 311694, 311693, 311309, 310040, 310681, 310823, 310798, 311056, 310416, 311408, 311344, 311906, 311624, 312017, 312033, 311943, 311048, 311409, 311495, 311758, 311093, 311447, 311885, 310367, 311489, 310352, 311975, 311977, 311339, 310376, 310379, 311653, 311199, 310385, 310414, 310485, 311260, 310244, 311365, 311366, 310324, 310033, 310304, 312010, 312011, 310918, 310919, 312007, 310156, 310819, 311765, 311490, 311351, 311063, 310899, 310903, 311022, 311025, 311088, 310660, 311274, 312146, 310027, 310909, 311922, 310134, 310041, 310232, 310613, 311497, 312062, 311575, 311740, 311970, 310538, 310644, 310873, 311822, 311536, 311980, 310188, 310574, 311383, 310925, 310958, 310960, 311030, 311019, 311179, 311180, 310121, 311087, 310877, 310449, 310450, 310487, 311515, 311427, 311516, 311452, 310219, 310239, 312203 All serial numbers in the market
Root Cause
Device Design
Action Taken
The firm, Roche sent a "Technical Bulletin" and an letter dated October 3, 2012 to its customers. The letter and bulletin described the product, problem and actions to be taken. The customers were informed that Ventana is aggressively working on solutions to this issue. Until mitigations to the overflow condition are available for implementation; inform all personnel in your organization that work with the BenchMark ULTRA or DISCOVERY ULTRA instrument about the potential for fluid overflow to occur during decontamination cycles; follow the instructions provided in the letter to avoid the documented failure mode and follow the instructions provided in the technical bulletin. Contact your local support center with any questions or concerns or call 520-877-7191.