FDA Adverse Event Malfunction Summary report: N

ALBP ALBUMIN BCP

MDR report key: 16531768 · Received March 13, 2023

Report

Report Number
1823260-2023-00792
Event Type
Malfunction
Date Received
March 13, 2023
Date of Event
February 22, 2023
Report Date
April 10, 2023
Manufacturer
ROCHE DIAGNOSTICS
Product Code
CJW
UDI-DI
04015630928064
PMA / PMN Number
K844426
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NZ
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

QUALITY CONTROLS WERE ACCEPTABLE ON THE DAY OF THE EVENT. THE INVESTIGATION COULD NOT IDENTIFY A PRODUCT PROBLEM. THE CAUSE OF THE EVENT COULD NOT BE DETERMINED. THE ISSUE IS CONSISTENT WITH INCORRECT PRE-ANALYTIC SAMPLE HANDLING.

Additional Manufacturer Narrative · 0

CALIBRATION DATA WAS OK.

Description of Event or Problem · 0

THE INITIAL REPORTER STATED THEY RECEIVED DISCREPANT RESULTS FOR ONE PATIENT SAMPLE TESTED WITH ALBP ALBUMIN BCP ON A COBAS 8000 C702 MODULE (SERIAL NUMBER (B)(4). NO QUESTIONABLE RESULTS WERE REPORTED OUTSIDE OF THE LABORATORY. THE SAMPLE INITIALLY RESULTED IN AN ALBUMIN VALUE OF 82.9 G/L AND IT REPEATED AS 40.0 G/L.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1649887 ALBP ALBUMIN BCP BROMCRESOL PURPLE DYE-BINDING, ALBUMIN CJW ROCHE DIAGNOSTICS ALB BCP 65252401 04015630928064

Patients

Seq Age Sex Outcome Treatment
1 67 YR Male