BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    I-STAT CG8+ CARTRIDGE

    MDR report key: 10448295 · Received August 25, 2020

    Report

    Report Number
    2245578-2020-00089
    Event Type
    Malfunction
    Date Received
    August 25, 2020
    Date of Event
    August 5, 2020
    Report Date
    September 25, 2020
    Manufacturer
    ABBOTT POINT OF CARE
    Product Code
    CHL
    UDI-DI
    10054749000163
    PMA / PMN Number
    K940918
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    BE
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    APOC INCIDENT # (B)(4). APOC LABELING WILL BE EVALUATED DURING THE INVESTIGATION AS PERTAINING TO THE EVENT.

    Additional Manufacturer Narrative · 1

    (B)(4). THE INVESTIGATION WAS COMPLETED ON 24-SEP-2020. A REVIEW OF THE DEVICE HISTORY RECORD (DHR) CONFIRMED THE CARTRIDGE LOT MET FINISHED GOODS (FG) RELEASE CRITERIA. RETAIN TESTING MET THE ACCEPTANCE CRITERIA FOUND IN Q04.01.003 REV. AF, APPENDIX 1 - PRODUCT COMPLAINT LEVEL 2 AND LEVEL 3 INVESTIGATION PROCEDURE. NO DEFICIENCY HAS BEEN DETERMINED FOR CG8+ LOT W20145.

    Description of Event or Problem · 1

    ON 08/06/2020, ABBOTT POINT OF CARE WAS CONTACTED BY A CUSTOMER REGARDING I-STAT CG8+ CARTRIDGES THAT YIELDED SUSPECTED DISCREPANT POTASSIUM RESULTS OF 9 AND >9 ON A (B)(6) YEAR OLD MALE PATIENT WITH ACUTE RESPIRATORY DECOMPENSATION. TESTING WAS PERFORMED WHEN THE PATIENT WAS ADMITTED ON (B)(6) 2020. THE PATIENT PASSED AWAY ON (B)(6) 2020. THERE WAS NO ADDITIONAL PATIENT INFORMATION AVAILABLE AT THE TIME OF THIS REPORT. RETURN PRODUCT IS NOT AVAILABLE FOR INVESTIGATION. METHOD: I-STAT, DATE: (B)(6) 2020, TESTED: 15:33, POTASSIUM: 9.0MEQ/L, SAMPLE: PLASMA, VENOUS SAMPLE, COLLECTED IN LITHIUM EVACUATED TUBE; I-STAT, (B)(6) 2020, 15:41, 5.2MEQ/L, WB, CAPILLARY SAMPLE, COLLECTED IN A CAPILLARY WITH LITHIUM HEPARIN; I-STAT, (B)(6) 2020, 16:48, >9.0MEQ/L, WB, CAPILLARY SAMPLE, COLLECTED IN A CAPILLARY WITH LITHIUM HEPARIN. THERE ARE NO INJURIES ASSOCIATED WITH THIS EVENT. AT THIS TIME THERE IS NO REASON TO SUSPECT A MALFUNCTION EXISTS. THE REPORTING DECISION WAS BASED ON LIMITED INFORMATION AVAILABLE THAT SUGGESTS THE PRODUCT WAS NOT PERFORMING WITHIN THE VARIABILITY OF THE ASSAY. THE INVESTIGATION IS UNDERWAY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    916226 I-STAT CG8+ CARTRIDGE CG8+ CARTRIDGE CHL ABBOTT POINT OF CARE NA W20145 10054749000163

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR