FDA Adverse Event Other Summary report: N

ADVIA CENTAUR HAV IGM ASSAY

MDR report key: 1315783 · Received February 17, 2009

Report

Report Number
1219913-2009-00014
Event Type
Other
Date Received
February 17, 2009
Date of Event
January 26, 2009
Report Date
January 27, 2009
Manufacturer
SIEMENS HEALTHCARE DIAGNOSTICS INC.
Product Code
LOL
PMA / PMN Number
K081716
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE CUSTOMER DECLINED SERVICE - NO FURTHER ACTION TAKEN. THE CAUSE FOR THE DISCORDANT ADVIA CENTAUR (B)(6) IGM RESULT IS UNK. NO FURTHER EVAL OF THE DEVICE IS REQUIRED. A SAMPLE FROM THIS PT HAS BEEN REQUESTED FOR FURTHER EVAL.

Description of Event or Problem · 1

A REACTIVE ADVIA CENTAUR (B)(6) IGM RESULT AND A NON-REACTIVE (B)(6) TOTAL RESULT WERE OBTAINED FOR A PT SAMPLE. PT TREATMENT WAS NOT PRESCRIBED OR ALTERED. THERE WAS NO REPORT OF ADVERSE HEALTH CONSEQUENCES DUE TO THE DISCORDANT (B)(6) 1GM RESULT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ADVIA CENTAUR HAV IGM ASSAY HEPATITIS A VIRUS IGM ASSAY LOL SIEMENS HEALTHCARE DIAGNOSTICS INC. NA 131

Patients

Seq Age Sex Outcome Treatment
1