FDA Adverse Event Injury Summary report: N

INSTRUMENT MANAGER SOFTWARE

MDR report key: 12664921 · Received October 19, 2021

Report

Report Number
MW5104763
Event Type
Injury
Date Received
October 19, 2021
Date of Event
October 4, 2021
Report Date
October 15, 2021
Manufacturer
DATA INNOVATIONS LLC
Product Code
JQP
Adverse Event
Yes
Report Source
Voluntary report
Reporter Location
VT, US
Reporter Occupation
003

Narratives

Description of Event or Problem · 1

(B)(4) (A DISTRIBUTOR OF DATA INNOVATIONS' INSTRUMENT MANAGER SOFTWARE) REPORTED AN EVENT TO DATA INNOVATIONS (DI) ON BEHALF OF (B)(6) ON (B)(6) 2021. A CRITICAL RESULT WAS REPORTED TO THE WRONG CAREGIVER DUE TO AN INCORRECT ROOM NUMBER. THE SITE CONFIRMED THAT WHEN THE CRITICAL RESULT WAS REPORTED, THE CORRECT PATIENT NAME, DOB, TEST AND RESULT WERE PROVIDED TO THE CAREGIVER. BASED ON THE RESULT, THE CRITICAL VALUE WAS ACTED UPON FOR THE INCORRECT PATIENT. A CAREGIVER REPORTED THAT THE PATIENT CHART WAS NOT UPDATED. INVESTIGATION AT THE CUSTOMER SITE DETERMINED THE RESULT WAS GIVEN TO THE INCORRECT CAREGIVER BASED ON THE ROOM AND LOCATION, RESULTING IN A 6-HOUR DELAY IN TREATMENT ON THE CORRECT PATIENT. NO PATIENT HARM ON EITHER PATIENT WAS REPORTED TO DI. THIS WAS NOT A MALFUNCTION OF INSTRUMENT MANAGER. REPORT IS BEING SUBMITTED DUE TO THE INCORRECT PATIENT BEING UNNECESSARILY TREATED. FDA SAFETY REPORT ID# (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1559981 INSTRUMENT MANAGER SOFTWARE CALCULATOR/DATA PROCESSING MODULE, FOR CLINICAL USE JQP DATA INNOVATIONS LLC V8.15.11

Patients

Seq Age Sex Outcome Treatment
1 Other