FDA Adverse Event Malfunction Summary report: N

ATELLICA SOLUTION

MDR report key: 10796220 · Received November 5, 2020

Report

Report Number
2432235-2020-00435
Event Type
Malfunction
Date Received
November 5, 2020
Date of Event
September 2, 2020
Report Date
November 5, 2020
Manufacturer
SIEMENS HEALTHCARE DIAGNOSTICS INC.
Product Code
JJE
UDI-DI
00630414002439
PMA / PMN Number
K151792
Removal / Correction Number
2432235-11/04/2020-012-C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE CUSTOMER CONTACTED SIEMENS TO REPORT THAT THE OPERATOR OF AN ATELLICA IM 1300 INSTRUMENT SCANNED A NEW HIGH SENSITIVITY TROPONIN (TNIH) TDEF AND FOUND THAT THE SERUM INDICES PARAMETERS OF HEMOLYSIS, ICTERUS AND LIPEMIA (HIL) WERE CHANGED FROM ENABLED TO DISABLED WHILE REVIEWING THE INSTRUMENT'S AUDIT TRAIL LOG. SIEMENS REVIEWED THE AUDIT TRAIL LOG FROM THE CUSTOMER SITE AND FOUND THAT THE CUSTOMER HAD RE-ENABLED THE SERUM INDICES PARAMETERS OF HEMOLYSIS, ICTERUS AND LIPEMIA (HIL) PRIOR TO RUNNING ANY SAMPLES. THE CAUSE OF THE HIL PARAMETERS SWITCHING FROM ENABLED TO DISABLED WAS THE SCANNING OF THE TNIH TDEF. THE INSTRUMENT IS WORKING WITHIN SPECIFICATIONS. NO FURTHER EVALUATION OF THIS INSTRUMENT IS NEEDED. AN URGENT MEDICAL DEVICE CORRECTION (UMDC) ASW21-01.A.US WAS SENT TO US CUSTOMERS AND AN URGENT FIELD SAFETY NOTICE (UFSN) ASW21-01.A.OUS WAS SENT TO OUTSIDE THE US (OUS) CUSTOMERS IN (B)(6) OF 2020. THE UMDC AND UFSN EXPLAIN THE BEHAVIOR DESCRIBED ABOVE AND REQUESTS CUSTOMERS TO ENSURE THAT AFTER SCANNING A NEW VERSION OF THE 2D MASTER CURVE AND TEST DEFINITION BARCODES INCLUDED IN THE REAGENT PACKAGE, THE SETTINGS OF THE CUSTOMIZED FIELDS MUST BE VERIFIED, IF APPLICABLE, ON THE "SETUP/TEST DEFINITION/IM TEST DEFINITION SCREEN" AND IF NECESSARY, CUSTOMIZED SETTINGS MUST BE RE-ENTERED. THE UMDC AND UFSN DELINEATE THAT SOFTWARE IS BEING DEVELOPED TO RESOLVE THE BEHAVIOR. TO DATE, THERE ARE NO ALLEGATIONS OF INJURY DUE TO THIS BEHAVIOR.

Description of Event or Problem · 1

THE OPERATOR OF AN ATELLICA IM 1300 INSTRUMENT SCANNED A NEW HIGH SENSITIVITY TROPONIN (TNIH) TDEF AND FOUND THAT THE SERUM INDICES PARAMETERS OF HEMOLYSIS, ICTERUS AND LIPEMIA (HIL) WERE CHANGED FROM ENABLED TO DISABLED WHILE REVIEWING THE INSTRUMENT'S AUDIT TRAIL LOG. THERE ARE NO KNOWN REPORTS OF PATIENT INTERVENTION OR ADVERSE HEALTH CONSEQUENCES DUE TO THE HIL SETTINGS BEING SET TO THE DEFAULT VALUE OF DISABLE AFTER SCANNING THE TNIH TDEF.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1256703 ATELLICA SOLUTION ATELLICA IM 1300 JJE SIEMENS HEALTHCARE DIAGNOSTICS INC. ATELLICA IM 1300 00630414002439

Patients

Seq Age Sex Outcome Treatment
1