BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ID NOW COVID-19 ASSAY

    MDR report key: 15084887 · Received July 22, 2022

    Report

    Report Number
    1221359-2022-03627
    Event Type
    Malfunction
    Date Received
    July 22, 2022
    Date of Event
    June 15, 2022
    Report Date
    July 22, 2022
    Manufacturer
    ABBOTT DIAGNOSTICS SCARBOROUGH, INC.
    Product Code
    QJR
    UDI-DI
    04571226475027
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    THIS SUPPLEMENTAL REPORT IS BEING SUBMITTED TO PROVIDE THE INITIAL AND INVESTIGATION CONCLUSION. THIS REPORT IS BEING FILED ON AN INTERNATIONAL PRODUCT, LIST NUMBER 190-000J THAT HAS A SIMILAR PRODUCT DISTRIBUTED IN THE US, LIST NUMBER 190-000. TESTING WAS PERFORMED AT ABBOTT DIAGNOSTICS (B)(4), INC. ON RETAINED KIT LOT M188847 WITH INTERNAL POSITIVE QUALITY CONTROL SAMPLES AND NEGATIVE QUALITY CONTROL SWABS. ALL TEST RESULTS WERE VALID AND PERFORMED AS EXPECTED. ADDITIONALLY, THE MANUFACTURING RECORDS AND QUALITY CONTROL RELEASE TESTING WAS REVIEWED FOR TEST KIT PART NUMBER 190-000J / LOT M188847 AND TEST BASE PART NUMBER 190-430 / LOT M188847. THE LOT MET THE REQUIRED RELEASE SPECIFICATIONS. THE CURRENT OVERALL INCIDENT RATE FOR FALSE POSITIVE PATIENT RESULTS (CONFIRMED AND UNCONFIRMED, CONFLICTING RESULTS) FOR THIS SPECIFIC LOT BASED ON THE TOTAL QUANTITY OF DEVICES MANUFACTURED FOR DISTRIBUTION IS (B)(4). IN CONCLUSION, ABBOTT DIAGNOSTICS (B)(4) WAS UNABLE TO DETERMINE THE EXACT ROOT CAUSE OF THE REPORTED ISSUE HOWEVER A POSSIBLE ASSIGNABLE ROOT CAUSE IS PATIENT SAMPLE INTERFERENCE. SUBSTANCES IN THE SAMPLE ITSELF MAY HAVE INTERFERED WITH THE REACTION. PLEASE REFER TO RELATED MFR REPORT NUMBERS: 1221359-2022-03626 THROUGH 1221359-2022-03628.

    Description of Event or Problem · 0

    THE CUSTOMER REPORTED 3 FALSE POSITIVE RESULTS WITH THE ID NOW COVID-19 PERFORMED USING TWO DIFFERENT LOT NUMBERS (M180239 AND M188847). THIS MFR. REPORT ADDRESSES PATIENT RESULTS TWO (2) OF THREE(3). THE CUSTOMER REPORTED A FALSE POSITIVE RESULT WITH THE ID NOW COVID-19 ASSAY PERFORMED ON (B)(6) 2022 ON AN UNKNOWN SWAB GENERATED A POSITIVE RESULT. NO REPEAT TESTING ON THE ID NOW MACHINE WAS PERFORMED. THE PATIENT WAS TRANSFERED TO THE HOSPITAL ON A UNKNOWN DATE AND TESTED WITH AN UNKNOWN METHOD GENERATING A NEGATIVE RESULT. THE CUSTOMER STATED THE PATIENT WAS ASYMPTOMATIC. THE CUSTOMER CONFIRMED THERE WAS NO PATIENT HARM DUE TO THE TEST RESULTS

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    102851 ID NOW COVID-19 ASSAY MOLECULAR IVD FOR ID NOW COVID-19 QJR ABBOTT DIAGNOSTICS SCARBOROUGH, INC. M188847 04571226475027

    Patients

    Seq Age Sex Outcome Treatment
    1 Unknown