FDA Adverse Event Malfunction Summary report: N

ID NOW COVID-19

MDR report key: 12763764 · Received November 7, 2021

Report

Report Number
1221359-2021-03383
Event Type
Malfunction
Date Received
November 7, 2021
Date of Event
September 30, 2021
Report Date
November 30, 2021
Manufacturer
ABBOTT DIAGNOSTICS SCABOROUGH
Product Code
QJR
UDI-DI
04571226475027
PMA / PMN Number
EUA2000074
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

THE INVESTIGATION IS STILL IN PROGRESS. A SUPPLEMENTAL REPORT WILL BE PROVIDED AFTER COMPLETION. REFERENCE MANUFACTURE REPORT NUMBER: 1221359-2021-03382.

Additional Manufacturer Narrative · 0

TESTING WAS PERFORMED AT ABBOTT DIAGNOSTICS (B)(4), INC. ON RETAINED KIT LOT M162309 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 190-000J / LOT M162309 AND TEST BASE PART NUMBER 190-430 / LOT M162309. 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 M162309 SHOWED THAT THE COMPLAINT RATE IS (B)(4). ABBOTT DIAGNOSTICS (B)(4) WAS UNABLE TO DETERMINE THE EXACT ROOT CAUSE OF THE REPORTED ISSUES.

Description of Event or Problem · 0

THE CUSTOMER REPORTED DISCREPANT RESULTS WITH THE ID NOW COVID-19 ASSAY FOR MULTIPLE PATIENTS PERFORMED ON VARIOUS DATES. THIS MFR. REPORT ADDRESSES PATIENT 2 OF 2. THE CUSTOMER REPORTED CONFLICTING RESULT WITH THE ID NOW COVID-19 ASSAY PERFORMED ON (B)(6) 2021 ON A DIRECT TESTED NASOPHARYNGEAL NIPRO SWAB. REPEAT TESTING WAS PERFORMED ON THE SAME DAY ((B)(6) 2021) WITH PCR GENERATING NEGATIVE RESULTS. THE CUSTOMER STATED THE PATIENT WAS ASYMPTOMATIC. THE CUSTOMER REPORTED THERE WAS A DELAY IN THE PATIENT'S TREATMENT. THE PATIENT EXPERIENCED A DELAY IN PATIENT ADMISSION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1656777 ID NOW COVID-19 MOLECULAR IVD FOR ID NOW COVID-19 QJR ABBOTT DIAGNOSTICS SCABOROUGH M162309 04571226475027

Patients

Seq Age Sex Outcome Treatment
1 Female Other