FDA Adverse Event Malfunction Summary report: N

ID NOW COVID-19 ASSAY

MDR report key: 11809788 · Received May 11, 2021

Report

Report Number
1221359-2021-01453
Event Type
Malfunction
Date Received
May 11, 2021
Date of Event
April 9, 2021
Report Date
August 2, 2021
Manufacturer
ABBOTT DIAGNOSTICS SCARBOROUGH, INC.
Product Code
QJR
UDI-DI
10811877011269
PMA / PMN Number
EUA2000074
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 0

TESTING WAS PERFORMED AT ABBOTT DIAGNOSTICS SCARBOROUGH, INC. ON RETAINED KIT LOT M140860 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 190-000 / LOT M140860, TEST BASE PART NUMBER 190-430 / LOT M140860. 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 M140860 SHOWED THAT THE COMPLAINT RATE IS (B)(4) . IN CONCLUSION, ABBOTT DIAGNOSTICS SCARBOROUGH WAS UNABLE TO DETERMINE THE EXACT ROOT CAUSE OF THE REPORTED ISSUE HOWEVER A POSSIBLE ASSIGNABLE ROOT CAUSE IS SAMPLE INTERFERENCE OR CROSS CONTAMINATION. REVIEW OF COMPLAINTS AGAINST THE KIT LOT FOR THE REPORTED ISSUE INDICATES PRODUCT PERFORMANCE IS AS EXPECTED AND HAVE NOT IDENTIFIED A PRODUCT DEFICIENCY.

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS STILL IN PROGRESS. A SUPPLEMENTAL REPORT WILL BE PROVIDED AFTER COMPLETION.

Description of Event or Problem · 1

THE CUSTOMER REPORTED A FALSE POSITIVE RESULT WITH THE ID NOW COVID-19 ASSAY PERFORMED ON (B)(6) 2021 ON A DIRECT TESTED NASOPHARYNGEAL SWAB. REPEAT TESTING ON (B)(6) 2021 WAS PERFORMED ON THE ID NOW ASSAY WITH A NEW SAMPLE AND GENERATED NEGATIVE RESULTS. PCR CONFIRMATION TESTING WAS PERFORMED ON THE NASOPHARYNGEAL SWAB AND GENERATED NEGATIVE RESULTS. THE CUSTOMER STATED THE OUTPATIENT WAS SYMPTOMATIC WITH FEVER. THE CUSTOMER CONFIRMED THERE WAS NO PATIENT HARM DUE TO THE TEST RESULTS. ADDITIONALLY, THE CUSTOMER CONFIRMED THERE WAS NO DELAY OR IMPACT IN THE PATIENT'S TREATMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
705796 ID NOW COVID-19 ASSAY MOLECULAR IVD FOR ID NOW COVID-19 QJR ABBOTT DIAGNOSTICS SCARBOROUGH, INC. M140860 10811877011269

Patients

Seq Age Sex Outcome Treatment
1