BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ORTHO PROVUE

    MDR report key: 1060820 · Received June 12, 2008

    Report

    Report Number
    1056600-2008-00205
    Event Type
    Malfunction
    Date Received
    June 12, 2008
    Date of Event
    May 23, 2008
    Report Date
    June 12, 2008
    Manufacturer
    MICRO TYPING SYSTEMS, INC.
    Product Code
    KSZ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    A POSSIBLE ROOT CAUSE WAS DETERMINED. AN OCD FIELD ENGINEER VISITED THE CUSTOMER SITE AND DETERMINED THAT THE PROBE WAS BENT. THE FE REPLACED THE PROBE AND PERFORMED THE APPROPRIATE ADJUSTMENTS TO RETURN THE INSTRUMENT TO EXPECTED OPERATION. THIS CUSTOMER HAS NOT LOGGED ANY COMPLAINTS AGAINST THIS ANALYZER SINCE THIS INCIDENT. (B) (4).

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THE PROBE OF THE ORTHO PROVUE ANALYZER WAS BENT AND LEAKING FLUID. PROBE DRIP MAY LEAD TO DILUTION OF SAMPLE/ REAGENT, CARRY OVER AND/OR CROSS CONTAMINATION AND ERRONEOUS RESULTS WHICH COULD LEAD TO TRANSFUSION OF INCOMPATIBLE BLOOD.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ORTHO PROVUE AUTOMATED BLOOD GROUPING & ANTIBODY TEST SYSTEM KSZ MICRO TYPING SYSTEMS, INC. NA NA

    Patients

    Seq Age Sex Outcome Treatment
    1