FDA Adverse Event Malfunction Summary report: N

ALERE CHOLESTECH LDX ANALYZER (POWER SUPPLY)

MDR report key: 11282361 · Received February 4, 2021

Report

Report Number
2027969-2021-00010
Event Type
Malfunction
Date Received
February 4, 2021
Report Date
February 4, 2021
Manufacturer
ALERE SAN DIEGO, INC.
Product Code
JJE
PMA / PMN Number
K120615
Removal / Correction Number
2027969-02/14/19-0001-C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

POWER SUPPLY LOT (1837D) WAS ASSOCIATED WITH FIELD ACTION 2027969-02/14/19-001-C FOR A DEFECTIVE POWER SUPPLY. THE DEFECTIVE POWER SUPPLY RESULTS IN AN INABILITY TO POWER ON THE LDX ANALYZER. NO FURTHER INVESTIGATION WILL BE PURSUED UNDER THIS CASE.

Description of Event or Problem · 1

CUSTOMER REPORTS POWER ISSUE ON LDX. POWER CORDS ARE NOT VISIBLY DAMAGED. NO BURNING, NO MELTING, NO SMOKING, NO INJURY. ISSUE WAS RESOLVED WITH AN ALTERNATE LDX POWER CORD. THREE LDX POWER SUPPLIES WERE RECEIVED BY THE INVESTIGATOR ON 1 FEB 2021 AND IT WAS CONFIRMED THE POWER SUPPLIES HAD IDENTIFIER CODE 1837D, WHICH WERE PART OF THE LDX POWER SUPPLY RECALL. NO ADVERSE OUTCOMES REPORTED. THERE WERE THREE LDX ANALYZERS CORRESPONDING WITH THREE AFFECTED LDX POWER SUPPLIES. PLEASE SEE MDRS 2027969-2021-00009 AND 2027969-2021-00011 FOR THE ALTERNATE LDX ANALYZERS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
178135 ALERE CHOLESTECH LDX ANALYZER (POWER SUPPLY) CHOLESTEROL/LIPIDS ANALYZER JJE ALERE SAN DIEGO, INC. 14-874

Patients

Seq Age Sex Outcome Treatment
1