FDA Adverse Event Malfunction Summary report: N

ID NOW COVID-19 ASSAY

MDR report key: 12021080 · Received June 17, 2021

Report

Report Number
1221359-2021-01762
Event Type
Malfunction
Date Received
June 17, 2021
Date of Event
May 10, 2021
Report Date
November 29, 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
TN, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

THIS INVESTIGATION IS STILL IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE A SUPPLEMENTAL REPORT WILL BE PROVIDED. REFERENCE MFR. REPORT: 1221359-2021-01761.

Additional Manufacturer Narrative · 0

TESTING WAS PERFORMED AT ABBOTT DIAGNOSTICS SCARBOROUGH, INC. ON RETAINED KIT LOT 1022797 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: 1022797 , TEST BASE PART NUMBER 190-430 / LOT: 1022797 . THE LOT MET THE REQUIRED RELEASE SPECIFICATIONS. A REVIEW OF THE COMPLAINTS REPORTED AS FALSE NEGATIVE PATIENT RESULTS (CONFIRMED AND UNCONFIRMED, CONFLICTING RESULTS) RELATED TO KIT LOT 1022797 SHOWED THAT THE COMPLAINT RATE IS (B)(4). ABBOTT DIAGNOSTICS SCARBOROUGH WAS UNABLE TO DETERMINE THE EXACT ROOT CAUSE OF THE REPORTED ISSUE, HOWEVER A POSSIBLE ASSIGNABLE ROOT CAUSE IS SAMPLE INTERFERENCE. SUBSTANCES IN THE SAMPLE ITSELF MAY HAVE INTERFERED WITH THE REACTION.

Description of Event or Problem · 0

THE CUSTOMER REPORTED TWO (2) FALSE NEGATIVE RESULTS WITH ID NOW COVID-19 ASSAY PERFORMED ON MULTIPLE DATES WITH MULTIPLE PATIENTS. THIS MFR. ADDRESSES PATIENT TWO (2) OF TWO (2). THE CUSTOMER REPORTED A FALSE NEGATIVE RESULT ON A DIRECT NASAL KITTED SWAB WITH ID NOW COVID-19 ASSAY PERFORMED ON (B)(6) 2021. CONFIRMATION TESTING WAS PERFORMED ON AN OUTSIDE LOCATION AND GENERATED POSITIVE RESULTS. PER THE CUSTOMER, THE PATIENT WAS SYMPTOMATIC. ADDITIONALLY, THERE WAS NO PATIENT HARM DUE TO TEST RESULTS. THERE WAS NO DELAY OR IMPACT OF TREATMENT DUE TO TEST RESULTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
911949 ID NOW COVID-19 ASSAY MOLECULAR IVD FOR ID NOW COVID-19 QJR ABBOTT DIAGNOSTICS SCARBOROUGH, INC 1022797 10811877011269

Patients

Seq Age Sex Outcome Treatment
1 Unknown