FDA Adverse Event Injury Summary report: N

ID NOW COVID-19 ASSAY

MDR report key: 12264756 · Received August 3, 2021

Report

Report Number
1221359-2021-02196
Event Type
Injury
Date Received
August 3, 2021
Date of Event
March 17, 2021
Report Date
October 19, 2021
Manufacturer
ABBOTT DIAGNOSTICS SCABOROUGH
Product Code
QJR
UDI-DI
10811877011269
PMA / PMN Number
EUA2000074
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

TESTING WAS PERFORMED AT ABBOTT DIAGNOSTICS SCARBOROUGH, INC. ON RETAINED KIT LOT 1010479 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 1010479 AND TEST BASE PART NUMBER 190-430/ LOT 1010479. 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 1010479 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. REVIEW OF COMPLAINTS AGAINST THE KIT LOT FOR THE REPORTED ISSUE INDICATES PRODUCT PERFORMANCE IS AS EXPECTED AND HAVE NOT IDENTIFIED A PRODUCT DEFICIENCY.

Additional Manufacturer Narrative · 1

THE REMAINDER OF THE INVESTIGATION REMAINS IN PROGRESS. A SUPPLEMENTAL REPORT WILL BE PROVIDED AFTER COMPLETION. REFERENCE MFR REPORT NUMBERS: 1221359-2021-02195, 1221359-2021-02197.

Description of Event or Problem · 1

THE CUSTOMER REPORTED INVALID RESULTS WITH THE ID NOW COVID-19 ASSAY FOR MULTIPLE PATIENTS PERFORMED ON (B)(6) 2021. THIS MFR. REPORT ADDRESSES PATIENT TWO OF THREE. THE CUSTOMER REPORTED INVALID RESULT WITH THE ID NOW COVID-19 ASSAY PERFORMED ON (B)(6) 2021 ON A DIRECT TESTED NASAL KITTED SWAB. REPEAT TESTING WAS PERFORMED WITH VALID RESULTS. THE CUSTOMER REPORTED THERE WAS A DELAY IN THE PATIENT'S TREATMENT. THE CUSTOMER REPORTED THAT THERE WAS A DELAY OF SURGERY DUE TO INVALID RESULT. THE PATIENT WAS BEDDED IN SINGLE HOSPITAL ROOM ON SURGICAL FLOOR UNTIL VALID RESULTS WERE PROVIDED. NO ADDITIONAL PATIENT INFORMATION, INCLUDING TREATMENT AND OUTCOME, WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1166504 ID NOW COVID-19 ASSAY MOLECULAR IVD FOR ID NOW COVID-19 QJR ABBOTT DIAGNOSTICS SCABOROUGH 1010479 10811877011269

Patients

Seq Age Sex Outcome Treatment
1 66 YR Other