FDA Adverse Event Malfunction Summary report: N

ELECSYS CMV IGG

MDR report key: 14208719 · Received April 26, 2022

Report

Report Number
1823260-2022-01184
Event Type
Malfunction
Date Received
April 26, 2022
Date of Event
March 1, 2022
Report Date
June 6, 2022
Manufacturer
ROCHE DIAGNOSTICS
Product Code
LFZ
UDI-DI
04015630940172
PMA / PMN Number
K131605
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BE
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE INVESTIGATION IS ONGOING.

Additional Manufacturer Narrative · 0

THE PATIENT'S SAMPLE WAS NOT AVAILABLE FOR INVESTIGATION. BASED ON THE PROVIDED INFORMATION, THE INVESTIGATION DID NOT IDENTIFY A PRODUCT PROBLEM. THE CAUSE OF THE EVENT COULD NOT BE DETERMINED.

Description of Event or Problem · 0

THE INITIAL REPORTER RECEIVED QUESTIONABLE ELECSYS CMV IGG RESULTS FOR ONE PATIENT TESTED ON A COBAS 8000 E 801 MODULE SERIAL NUMBER (B)(4). THE PATIENT HAD TWO SAMPLES COLLECTED. THE PATIENT'S ELECSYS CMV IGG RESULTS WERE REPORTED OUTSIDE THE LABORATORY. THE PATIENT'S SAMPLES WERE REPEATED ON A VIDAS ANALYZER AND A LIAISON ANALYZER. ON (B)(6) 2022, THE PATIENT'S FIRST SAMPLE WAS COLLECTED. THE PATIENT'S ELECSYS CMV IGG RESULT WAS 2.5 U/ML POSITIVE. THE PATIENT'S VIDAS CMV IGG RESULT WAS 0.135 UA/ML NEGATIVE. ON (B)(6) 2022, THE PATIENT'S SECOND SAMPLE WAS COLLECTED. THE PATIENT'S ELECSYS CMV IGG RESULT WAS "<1" U/ML NEGATIVE. THE PATIENT'S VIDAS CMV IGG RESULT WAS 19 UA/ML POSITIVE. THE PATIENT'S LIAISON CMV IGG RESULT WAS 63 U/ML POSITIVE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1528753 ELECSYS CMV IGG ENZYME LINKED IMMUNOABSORBENT ASSAY, CYTOMEGALOVIRUS LFZ ROCHE DIAGNOSTICS NA 56805401 04015630940172

Patients

Seq Age Sex Outcome Treatment
1 Unknown