BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ID NOW COVID-19 ASSAY

    MDR report key: 11713092 · Received April 23, 2021

    Report

    Report Number
    1221359-2021-01228
    Event Type
    Malfunction
    Date Received
    April 23, 2021
    Date of Event
    March 14, 2021
    Report Date
    March 11, 2022
    Manufacturer
    ABBOTT DIAGNOSTICS SCARBOROUGH, INC.
    Product Code
    QJR
    UDI-DI
    10811877011320
    PMA / PMN Number
    EUA2000074
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GM
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    TESTING WAS PERFORMED AT ABBOTT DIAGNOSTICS SCARBOROUGH, INC. ON RETAINED KIT LOT 1009983 WITH INTERNAL POSITIVE QUALITY CONTROL SAMPLES AND NEGATIVE QUALITY CONTROL SWABS. ALL TEST RESULTS WERE VALID AND PERFORMED AS EXPECTED. ADDITIONALLY, THE MANUFACTURING RECORDS AND QUALITY CONTROL RELEASE TESTING WAS REVIEWED FOR TEST KIT PART NUMBER 191-000 / LOT: 1009983, TEST BASE PART NUMBER 190-430 / LOT: 1009983. THE LOT MET THE REQUIRED RELEASE SPECIFICATIONS. A REVIEW OF THE COMPLAINTS REPORTED AS FALSE POSITIVE PATIENT RESULTS (CONFIRMED AND UNCONFIRMED, CONFLICTING RESULTS) RELATED TO KIT LOT 1009983 SHOWED THAT THE COMPLAINT RATE IS (B)(4). ABBOTT DIAGNOSTICS SCARBOROUGH WAS UNABLE TO DETERMINE THE EXACT ROOT CAUSE OF THE REPORTED ISSUE AS LOGFILES WERE NOT PROVIDED, HOWEVER A POSSIBLE ASSIGNABLE ROOT CAUSE IS PATIENT SAMPLE INTERFERENCE. SUBSTANCES IN THE SAMPLE ITSELF MAY HAVE INTERFERED WITH THE REACTION.

    Additional Manufacturer Narrative · 0

    THIS SUPPLEMENTAL REPORT IS BEING SUBMITTED TO RETRACT THE PREVIOUS INITIAL MDR REPORT FOR A FALSE POSITIVE. THIS REPORT IS A DUPLICATE REPORT FOR FALSE POSITIVES THAT ARE ALREADY COVERED IN MFR REFERENCE REPORT : 1221359-2021-00986.

    Additional Manufacturer Narrative · 1

    REFERENCE REPORTS: 1221359-2021-01227, 1221359-2021-01229, 1221359-2021-01230, 1221359-2021-01231. THE INVESTIGATION IS STILL IN PROGRESS. A SUPPLEMENTAL REPORT WILL BE PROVIDED AFTER COMPLETION.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED FALSE POSITIVE RESULTS WITH THE ID NOW COVID-19 ASSAY FOR MULTIPLE PATIENTS PERFORMED ON VARIOUS DATES. THIS REPORT ADDRESSES EVENT TWO (2) OF FIVE (5). THE CUSTOMER REPORTED ONE (1) FALSE POSITIVE RESULT WITH THE ID NOW COVID-19 ASSAY PERFORMED ON (B)(6) 2021 ON A DIRECT TESTED THROAT AND NASAL PURITAN "STERILE FOAM TIPPED APPLICATOR" REF 25-1506 1PF 100 SWABS. IT IS UNKNOWN IF REPEAT TESTING WAS PERFORMED. CONFIRMATION TESTING WAS PERFORMED ON NASAL AND THROAT SAMPLES WITH PCR GENERATED NEGATIVE RESULTS; CT VALUES NOT PROVIDED. NO ADDITIONAL PATIENT INFORMATION, INCLUDING TREATMENT AND OUTCOME, WAS PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    612305 ID NOW COVID-19 ASSAY MOLECULAR IVD FOR ID NOW COVID-19 QJR ABBOTT DIAGNOSTICS SCARBOROUGH, INC. 1009983 10811877011320

    Patients

    Seq Age Sex Outcome Treatment
    1 Unknown