FDA Adverse Event Malfunction Summary report: N

ARCHITECT B12 REAGENT KIT

MDR report key: 13176978 · Received January 6, 2022

Report

Report Number
3005094123-2022-00005
Event Type
Malfunction
Date Received
January 6, 2022
Date of Event
August 2, 2021
Report Date
March 22, 2022
Manufacturer
A.I.D.D LONGFORD
Product Code
CDD
UDI-DI
00380740014193
PMA / PMN Number
K121314
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UT, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

AN EVALUATION IS IN PROCESS. A FOLLOW UP REPORT WILL BE SUBMITTED WHEN THE EVALUATION IS COMPLETE.

Additional Manufacturer Narrative · 0

AN EVALUATION IS IN PROCESS. A FOLLOW UP REPORT WILL BE SUBMITTED WHEN THE EVALUATION IS COMPLETE.

Additional Manufacturer Narrative · 0

AFTER FURTHER EVALUATION, THE SUSPECT MEDICAL DEVICE WAS CHANGED TO ARCHITECT I2000SR, LIST 3M74 (IRVING, TX AS MANUFACTURING SITE) AND SUBMITTED UNDER MANUFACTURER REPORT NUMBER 3016438761-2022-00047-01. ALL FURTHER INFORMATION WILL BE DOCUMENTED UNDER MDR NUMBER 3016438761-2022-00047-01.

Description of Event or Problem · 0

THE CUSTOMER REPORTED A FALSELY ELEVATED ARCHITECT B12 RESULT ON A PATIENT. RESULTS PROVIDED: (B)(6) 2021, SID (B)(6)= 364 PG/ML< REPEATED ON (B)(6) 2021 = 274 PG/ML (BOTH RESULTS USING LOT# 23108UI00). NORMAL RANGE: 345-1485 PG/ML. NO IMPACT TO PATIENT MANAGEMENT WAS REPORTED.

Description of Event or Problem · 0

THE CUSTOMER REPORTED A FALSELY ELEVATED ARCHITECT B12 RESULT ON A PATIENT. RESULTS PROVIDED: (B)(6) 2021, SID (B)(6)= 364 PG/ML< REPEATED ON (B)(6) 2021 = 274 PG/ML (BOTH RESULTS USING LOT# 23108UI00). NORMAL RANGE: 345-1485 PG/ML. NO IMPACT TO PATIENT MANAGEMENT WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
51539 ARCHITECT B12 REAGENT KIT RADIOASSAY, VITAMIN B12 CDD A.I.D.D LONGFORD 7K61-37 23108UI00 00380740014193

Patients

Seq Age Sex Outcome Treatment
1 Unknown ARC I2000SR INST, 03M74-02, ISR61701| ARC I2000SR INST, 03M74-02, ISR61701