BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ID NOW COVID-19 ASSAY

    MDR report key: 12139786 · Received July 8, 2021

    Report

    Report Number
    1221359-2021-01904
    Event Type
    Injury
    Date Received
    July 8, 2021
    Date of Event
    June 3, 2021
    Report Date
    August 19, 2021
    Manufacturer
    ABBOTT DIAGNOSTICS SCARBOROUGH, INC.
    Product Code
    QJR
    UDI-DI
    10811877011320
    PMA / PMN Number
    EUA2000074
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FR
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 0

    TESTING WAS PERFORMED AT ABBOTT DIAGNOSTICS SCARBOROUGH, INC. ON RETAINED KIT LOT 1022562 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: 1022562, TEST BASE PART NUMBER 190-430 / LOT: 1022562. 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 1022562 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 OR CROSS CONTAMINATION.

    Additional Manufacturer Narrative · 1

    REFERENCE NUMBER: 1221359-2021-01903. THE INVESTIGATION IS STILL IN PROGRESS. A SUPPLEMENTAL REPORT WILL BE PROVIDED AFTER COMPLETION.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED TWO FALSE POSITIVE RESULTS WITH THE ID NOW COVID-19 ASSAY. THIS REPORT ADDRESSES PATIENT TWO OF TWO . THE CUSTOMER REPORTED A FALSE POSITIVE RESULT PERFORMED ON (B)(6) 2021 ON A NASOPHARYNGEAL SWAB IN VIRAL TRANSPORT MEDIUM. REPEAT TESTING WAS PERFORMED ON (B)(6) 2021 AND GENERATED NEGATIVE RESULTS (SAMPLE WAS FROZEN IN VIRAL TRANSPORT MEDIUM) PRIOR TO TESTING. PCR CONFIRMATION TESTING (PANTHER [HOLOGIC] [APTIMA], PASTEUR, TIB MOLBIOL SCREENING KIT) ON A CITOSWAB IN VIRAL TRANSPORT MEDIA GENERATED NEGATIVE RESULTS. THE CUSTOMER STATED THE PATIENT WAS NOT SYMPTOMATIC. THE CUSTOMER CONFIRMED THERE WAS NO PATIENT HARM DUE TO THE TEST RESULTS. ADDITIONALLY, THE CUSTOMER REPORTED THE EVENT LED TO A DELAY IN A MEDICAL PROCEDURE AS THE PATIENT WAS LATE TO BE TRANSFERRED TO THE CORRECT DEPARTMENT IN THE HOSPITAL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1032167 ID NOW COVID-19 ASSAY MOLECULAR IVD FOR ID NOW COVID-19 QJR ABBOTT DIAGNOSTICS SCARBOROUGH, INC. 1022562 10811877011320

    Patients

    Seq Age Sex Outcome Treatment
    1 19 YR Other