BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SOLANA SARS-COV-2 ASSAY (FRZ MMX)

    MDR report key: 14715606 · Received June 16, 2022

    Report

    Report Number
    0002024674-2022-07782
    Event Type
    Malfunction
    Date Received
    June 16, 2022
    Date of Event
    May 3, 2021
    Report Date
    June 16, 2022
    Manufacturer
    DIAGNOSTIC HYBRIDS, INC.
    Product Code
    QJR
    UDI-DI
    30014613339656
    PMA / PMN Number
    EUA203087
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WA, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    INVESTIGATION SUMMARY: A QUIDEL REPRESENTATIVE VISITED THE SITE AND OBSERVED PROCEDURAL ERRORS THAT MAY HAVE CONTRIBUTED TO THE EVENT. ISSUE RESOLVED WHEN CUSTOMER IMPLEMENTED DECONTAMINATION PROCEDURE, INDICATING LIKELY CONTAMINATION. ROOT CAUSE: UNABLE TO DETERMINE. SOURCE: PHONE.

    Description of Event or Problem · 0

    REPORTED ONE FALSE POSITIVE SARS RESULT. UNKNOWN IF THE RESULT WAS CONFIRMED. CONFIRMATION METHOD(S) NOT PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1858193 SOLANA SARS-COV-2 ASSAY (FRZ MMX) SOLANA SARS-COV-2 ASSAY (FRZ MMX) QJR DIAGNOSTIC HYBRIDS, INC. Coronavirus 188317 30014613339656

    Patients

    Seq Age Sex Outcome Treatment
    1 Unknown