FDA Adverse Event Other Summary report: N

DIMENSION CLINICAL CHEMISTRY SYSTEM

MDR report key: 1221806 · Received November 3, 2008

Report

Report Number
2517506-2008-00099
Event Type
Other
Date Received
November 3, 2008
Date of Event
September 23, 2008
Report Date
October 28, 2008
Manufacturer
SIEMENS HEALTHCARE DIAGNOSTICS, INC
Product Code
MTF
PMA / PMN Number
P0000021
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

ANALYSIS OF THE INSTRUMENT AND INSTRUMENT DATA INDICATE THAT THE CAUSE FOR THE FALSELY ELEVATED TPSA RESULT IS UNKNOWN. THE INSTRUMENT IS PERFORMING WITHIN SPECIFICATIONS. NO FURTHER EVALUATION OF THE DEVICE IS REQUIRED.

Description of Event or Problem · 1

A FALSELY ELEVATED TPSA RESULT WAS OBTAINED ON A PATIENT SAMPLE. THE RESULT WAS REPORTED TO THE PHYSICIAN WHO QUESTIONED THE RESULT. THE SAMPLE WAS REPEATED BY ALTERNATE METHODOLOGY AND A NEGATIVE RESULT WAS OBTAINED. PATIENT TREATMENT WAS NOT ALTERED OR PRESCRIBED. THERE WAS NO REPORT OF ADVERSE HEALTH CONSEQUENCES AS A RESULT OF THE FALSELY ELEVATED TPSA RESULT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DIMENSION CLINICAL CHEMISTRY SYSTEM TPSA FLEX REAGENT CARTRIDGE MTF SIEMENS HEALTHCARE DIAGNOSTICS, INC NA EB9184

Patients

Seq Age Sex Outcome Treatment
1 68 YR