BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ID NOW COVID-19 ASSAY

    MDR report key: 12027935 · Received June 18, 2021

    Report

    Report Number
    1221359-2021-01707
    Event Type
    Malfunction
    Date Received
    June 18, 2021
    Date of Event
    May 2, 2021
    Report Date
    June 18, 2021
    Manufacturer
    ABBOTT DIAGNOSTICS SCARBOROUGH, INC.
    Product Code
    QJR
    UDI-DI
    10811877011320
    PMA / PMN Number
    EUA2000074
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FR
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    TESTING WAS PERFORMED AT ABBOTT DIAGNOSTICS (B)(4) ON RETAINED KIT LOT 1022490 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:1022490, TEST BASE PART NUMBER 190-430 / LOT: 1022490. 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 1022490 SHOWED THAT THE COMPLAINT RATE IS (B)(4). ABBOTT DIAGNOSTICS (B)(4) WAS UNABLE TO DETERMINE THE EXACT ROOT CAUSE OF THE REPORTED ISSUE AS THE LOGFILES WERE NOT PROVIDED. (B)(6). MFR REPORT REFERENCE: 1221359-2021-01706, 1221359-2021-01708, 1221359-2021-01709.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED FOUR (4) FALSE POSITIVE RESULTS WITH THE ID NOW COVID-19 ASSAY FOR FOUR (4) PATIENTS. THIS MFR. REPORT ADDRESSES PATIENT TWO (2) OF FOUR (4). THE CUSTOMER REPORTED A FALSE POSITIVE RESULT WITH THE ID NOW COVID-19 ASSAY PERFORMED ON (B)(6) 2021. PCR CONFIRMATION TESTING (XPERT XPRESS SARS-COV-2 [CEPHIED]) PERFORMED ON (B)(6) 2021 GENERATED NEGATIVE RESULT. THE CUSTOMER REPORTED THAT THIS PATIENT HAS BREAST CANCER AND FOLLOWING A CHEMOTHERAPY AND GRANOCYTE 34 & OTHER TREATMENTS, SHE WAS ADMITTED TO EMERGENCY DEPARTMENT WITH NAUSEA AND VOMITING . ADDITIONALLY,THE CUSTOMER CONFIRMED THERE WAS NO DEATH OR ADVERSE EVENT OR SERIOUS DETERIORATION IN HEALTH WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    922648 ID NOW COVID-19 ASSAY MOLECULAR IVD FOR ID NOW COVID-19 QJR ABBOTT DIAGNOSTICS SCARBOROUGH, INC. 1022490 10811877011320

    Patients

    Seq Age Sex Outcome Treatment
    1