FDA Adverse Event Malfunction Summary report: Y

CLIP COVID RAPID ANTIGEN TEST

MDR report key: 14690720 · Received June 14, 2022

Report

Report Number
3015104453-2022-00026
Event Type
Malfunction
Date Received
June 14, 2022
Date of Event
January 12, 2022
Report Date
June 14, 2022
Manufacturer
LUMINOSTICS, INC DBA CLIP HEALTH
Product Code
QKP
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

TEST DATA REVIEW: ANALYSIS OF FIELD DATA FOR LOT CC-10148-A PERFORMED IN (B)(6) 2022 SHOWED THAT THE MEAN TEST-LINE VALUE OF THE FIELD NEGATIVES MATCHED THE MEAN VALUE OF IN-HOUSE BUFFER NEGATIVES TO WITHIN SPECIFICATIONS. PRODUCT IS PERFORMING AS EXPECTED.

Description of Event or Problem · 0

OUT OF 85 RUN, 2 THAT TESTED POSITIVE, RETESTED, AND CAME BACK NEGATIVE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1658169 CLIP COVID RAPID ANTIGEN TEST SARS-COV-2 ANTIGEN TEST QKP LUMINOSTICS, INC DBA CLIP HEALTH MDL001, CLIP ANALYZER AND MDL002, CLIP COVID RAPID ANTIGEN TEST KIT CC-10148-A

Patients

Seq Age Sex Outcome Treatment
1 Unknown