FDA Adverse Event Injury Summary report: N

INSTRUMENT MANAGER

MDR report key: 11701978 · Received April 20, 2021

Report

Report Number
MW5100911
Event Type
Injury
Date Received
April 20, 2021
Date of Event
February 2, 2021
Report Date
April 19, 2021
Manufacturer
DATA INNOVATIONS LLC
Product Code
JQP
Adverse Event
Yes
Report Source
Voluntary report
Reporter Location
VT, US
Reporter Occupation
003

Narratives

Description of Event or Problem · 1

ROCHE DIAGNOSTICS (A DISTRIBUTOR OF DATA INNOVATIONS' INSTRUMENT MANAGER SOFTWARE) REPORTED AN ISSUE TO DATA INNOVATIONS (DI) ON BEHALF OF (B)(6) ON (B)(6) 2021: AN INITIAL RESULT FOR A FERRITIN TEST WAS RECEIVED FROM THE ROCHE COBAS 8000 ANALYZER WITH A HIGH RESULT FLAG. THE SAMPLE WAS HELD BASED ON A CONFIGURATION SETTING AND THEN RERAN FOR DILUTION. THE SECOND RUN PROVIDED AN ERRONEOUS RESULT, WITH A VALUE OF '2000' AND HIGH FLAG BUT WITH A DILUTION OF X20. AS A RESULT, THE SAMPLE WAS RUN A THIRD TIME ON DILUTION. WHILE THE RERUN WAS RUNNING, THE LAB TECH MANUALLY RELEASED THE ORIGINAL RESULT FROM THE INSTRUMENT WITH A VALUE OF '2000' AND HIGH FLAG. THIS WAS REPORTED AS A CRITICAL/POSITIVE RESULT AND THE PATIENT WAS GIVEN A DIAGNOSIS OF HELPPHAGOCYTIC-LYMPHOHISTIOCYTOSIS (HLS). AS A RESULT, AN INCORRECT DIAGNOSIS WAS DISCUSSED WITH THE FAMILY, A SPECIALIST WAS CONSULTED, AND AN UNSCHEDULED BLOOD DRAW TOOK PLACE. THE FOLLOW-UP TESTING DETERMINED THAT THE RESULT WAS A FALSE POSITIVE. THIS IS NOT A MALFUNCTION OF INSTRUMENT MANAGER. REPORT IS BEING SUBMITTED DUE TO DATA INNOVATIONS BECOMING AWARE THAT THE ERRONEOUS RESULT BEING REPORTED TO THE PATIENT WHICH RESULTED IN A SPECIALIST CONSULTATION AND AN UNSCHEDULED BLOOD DRAW. FDA SAFETY REPORT ID# (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
588971 INSTRUMENT MANAGER CALCULATOR/DATA PROCESSING MODUL JQP DATA INNOVATIONS LLC V8.12.12

Patients

Seq Age Sex Outcome Treatment
1 Other