FDA Adverse Event Malfunction Summary report: N

ID NOW COVID 19 ASSAY

MDR report key: 12140076 · Received July 8, 2021

Report

Report Number
1221359-2021-01927
Event Type
Malfunction
Date Received
July 8, 2021
Date of Event
April 29, 2021
Report Date
August 17, 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
NJ, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

TESTING WAS PERFORMED AT ABBOTT DIAGNOSTICS SCARBOROUGH, INC. ON RETAINED KIT LOT 1023941 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 1023941, TEST BASE PART NUMBER 190-430 / LOT 1023941. 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 1023941 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, IT COULD POSSIBLY BE RELATED TO THE SPECIFIC PATIENT SAMPLE OR CROSS CONTAMINATION. REFERENCE MFR:REPORT: 1221359-2021-01951.

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS STILL IN PROGRESS. A SUPPLEMENTAL REPORT WILL BE PROVIDED AFTER COMPLETION. MFR REPORT: 1221359-2021-01951.

Description of Event or Problem · 1

THE CUSTOMER REPORTED 5 FALSE POSITIVE RESULTS WITH THE ID NOW COVID-19 ASSAY PERFORMED ON (B)(6) 2021. THIS MFR. REPORT ADDRESSES THE EVENTS ON (B)(6) 2021, AND IS ONE (1) OF TWO (2). THE CUSTOMER REPORTED FOUR (4) FALSE POSITIVE RESULTS WITH THE ID NOW COVID-19 ASSAY PERFORMED ON (B)(6) 2021, ON DIRECT TESTED NASOPHARYNGEAL KITTED SWABS. REPEAT TEST WAS NOT PERFORMED, PCR CONFIRMATION TEST GENERATED NEGATIVE RESULT (PLATFORM UNKNOWN). THE CUSTOMER STATED THE PATIENT WAS NOT SYMPTOMATIC. 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
1034633 ID NOW COVID 19 ASSAY MOLECULAR IVD FOR ID NOW COVID-19 QJR ABBOTT DIAGNOSTICS SCARBOROUGH, INC. 1023941 10811877011269

Patients

Seq Age Sex Outcome Treatment
1