FDA Adverse Event Malfunction Summary report: N

BD RAPID DETECTION OF SARS-COV-2 VERITOR¿

MDR report key: 12849160 · Received November 19, 2021

Report

Report Number
3006948883-2021-01010
Event Type
Malfunction
Date Received
November 19, 2021
Date of Event
October 27, 2021
Report Date
January 24, 2022
Manufacturer
BD RAPIS DIAGNOSTICS (SUZHOU) CO. LTD.
Product Code
QKP
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

H6: INVESTIGATION SUMMARY: THIS STATEMENT IS TO SUMMARIZE THE INVESTIGATION RESULTS REGARDING THE COMPLAINT THAT ALLEGES FALSE POSITIVE WHEN USING KIT RAPID DETECTION OF SARS-COV-2 VERITOR (MATERIAL # 256082), BATCH NUMBER 1213534. BD QUALITY PERFORMS A SYSTEMATIC APPROACH TO INVESTIGATE FALSE POSITIVE COMPLAINTS. THIS APPROACH INVOLVES REVIEW OF MANUFACTURING BATCH HISTORY RECORDS, TESTING OF RETENTION SAMPLES, AND TESTING OF CUSTOMER RETURNED SAMPLES, IF APPLICABLE. AN INVESTIGATION AND TESTING WERE PERFORMED ON THE BATCH NUMBER PROVIDED. THE REPORTED ISSUE WAS UNABLE TO BE CONFIRMED. THE ROOT CAUSE COULD NOT BE IDENTIFIED.

Additional Manufacturer Narrative · 0

A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS ANTICIPATED BUT IS NOT COMPLETE. UPON COMPLETION, A SUPPLEMENTAL REPORT WILL BE FILED. THERE IS NO 510(K) FOR THIS DEVICE AS IT IS AN EMERGENCY USE AUTHORIZATION. EUA# (B)(4).

Additional Manufacturer Narrative · 0

A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS ANTICIPATED BUT IS NOT COMPLETE. UPON COMPLETION, A SUPPLEMENTAL REPORT WILL BE FILED. THERE IS NO 510(K) FOR THIS DEVICE AS IT IS AN EMERGENCY USE AUTHORIZATION. EUA# (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED WHILE TESTING WITH BD RAPID DETECTION OF SARS-COV-2 VERITOR¿ A FALSE POSITIVE OCCURRED. THIS WAS REPORTED ONE TIME. THE PATIENT WAS TESTED A SECOND TIME PRIOR TO SURGERY, AND THAT RESULT WAS NEGATIVE. THERE WAS NO INDICATION THAT RESULTS WERE REPORTED OUT, AND THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: CUSTOMER IS REPORTING ONE FP WITH 256082, LOT NUMBER 1213534. THE PATIENT WAS SCHEDULED FOR SURGERY TODAY AND WAS TESTED IN THE AM, WHICH OUTPUT A POSITIVE RESULT FOR COVID. THE PATIENT WAS THEN TESTED ONCE MORE PRIOR TO SURGERY, AND THAT RESULT WAS NEGATIVE. NO OTHER CONFIRMATORY TESTING WAS PERFORMED. QUANTITY RECEIVED AND QUANTITY AFFECTED: 3 BOXES, 1 AFFECTED CUSTOMER IS REPORTING ONE FP WITH 256082, LOT NUMBER 1213534.

Description of Event or Problem · 0

IT WAS REPORTED WHILE TESTING WITH BD RAPID DETECTION OF SARS-COV-2 VERITOR¿ A FALSE POSITIVE OCCURRED. THIS WAS REPORTED ONE TIME. THE PATIENT WAS TESTED A SECOND TIME PRIOR TO SURGERY, AND THAT RESULT WAS NEGATIVE. THERE WAS NO INDICATION THAT RESULTS WERE REPORTED OUT, AND THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: CUSTOMER IS REPORTING ONE FP WITH 256082, LOT NUMBER 1213534. THE PATIENT WAS SCHEDULED FOR SURGERY TODAY AND WAS TESTED IN THE AM, WHICH OUTPUT A POSITIVE RESULT FOR COVID. THE PATIENT WAS THEN TESTED ONCE MORE PRIOR TO SURGERY, AND THAT RESULT WAS NEGATIVE. NO OTHER CONFIRMATORY TESTING WAS PERFORMED. § QUANTITY RECEIVED AND QUANTITY AFFECTED: 3 BOXES, 1 AFFECTED CUSTOMER IS REPORTING ONE FP WITH 256082, LOT NUMBER 1213534.

Description of Event or Problem · 0

IT WAS REPORTED WHILE TESTING WITH BD RAPID DETECTION OF SARS-COV-2 VERITOR¿ A FALSE POSITIVE OCCURRED. THIS WAS REPORTED ONE TIME. THE PATIENT WAS TESTED A SECOND TIME PRIOR TO SURGERY, AND THAT RESULT WAS NEGATIVE. THERE WAS NO INDICATION THAT RESULTS WERE REPORTED OUT, AND THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: CUSTOMER IS REPORTING ONE FP WITH 256082, LOT NUMBER 1213534. THE PATIENT WAS SCHEDULED FOR SURGERY TODAY AND WAS TESTED IN THE AM, WHICH OUTPUT A POSITIVE RESULT FOR COVID. THE PATIENT WAS THEN TESTED ONCE MORE PRIOR TO SURGERY, AND THAT RESULT WAS NEGATIVE. NO OTHER CONFIRMATORY TESTING WAS PERFORMED. § QUANTITY RECEIVED AND QUANTITY AFFECTED: 3 BOXES, 1 AFFECTED CUSTOMER IS REPORTING ONE FP WITH 256082, LOT NUMBER 1213534.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1739819 BD RAPID DETECTION OF SARS-COV-2 VERITOR¿ CORONAVIRUS ANTIGEN DETECTION SYSTEM QKP BD RAPIS DIAGNOSTICS (SUZHOU) CO. LTD. 1213534

Patients

Seq Age Sex Outcome Treatment
1 Unknown