FDA Adverse Event Malfunction Summary report: N

BD MAX¿ ENTERIC PARASITE PANEL

MDR report key: 16844034 · Received May 1, 2023

Report

Report Number
3007420875-2023-00034
Event Type
Malfunction
Date Received
May 1, 2023
Date of Event
February 20, 2023
Report Date
May 2, 2023
Manufacturer
GENEOHM SCIENCES CANADA, INC. (BD DIAGNOSTICS)
Product Code
PCH
UDI-DI
00382904429607
PMA / PMN Number
K143648
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

H6. THE COMPLAINT INVESTIGATION FOR DISCREPANT RESULTS WHEN USING THE BD MAX¿ ENTERIC PARASITE PANEL ASSAY (B)(4) LOTS 1138119, 2172819 AND 2110891 WAS PERFORMED BY THE REVIEW OF THE MANUFACTURING RECORDS, CUSTOMER¿S DATA ANALYSIS AND VERIFICATION OF COMPLAINTS HISTORY. REVIEW OF MANUFACTURING RECORDS OF BD MAX¿ ENTERIC PARASITE PANEL ASSAY INDICATED THAT LOTS 1138119, 2172819 AND 2110891 WERE MANUFACTURED ACCORDING TO SPECIFICATIONS AND MET PERFORMANCE REQUIREMENTS. CUSTOMER REPORTED JAGGED CURVES CAUSING POSITIVE RESULTS OF GLAMB AND CRYPTO TARGETS FOR TEN SAMPLES TESTED BETWEEN 2021-12-14 AND 2023-02-20, WITH THREE DIFFERENT KITS LOTS 1138119, 2172819 AND 2110891. OF THOSE SAMPLES, TWO WERE POSITIVE FOR GLAMB AND CRYPTO TARGETS, WHILE FOUR WERE POSITIVE ONLY FOR GLAMB AND FOUR WERE POSITIVE ONLY FOR CRYPTO TARGETS. THE CUSTOMER DID NOT MENTION IF THE SAMPLES WERE REPEATED. CUSTOMER PROVIDED TEN RUNS FILE FROM INSTRUMENT CT1566 FOR INVESTIGATION. MANUAL PCR CURVE ADJUDICATION WAS PERFORMED ON ALL TEN SAMPLES. ANALYSIS OF THE PCR CURVES REVEALED STEP DISLOCATION IN THE RAW PCR SIGNAL IN EVERY CHANNEL, RESULTING IN POSITIVE RESULTS ONLY FOR GLAMB TARGETS OR FOR GLAMB AND CRYPTO TARGETS. IT IS UNLIKELY THAT THESE ATYPICAL CURVES ARE DUE TO TRUE AMPLIFICATIONS AND THE ROOT CAUSE COULD NOT BE IDENTIFIED. NEVERTHELESS, MANUAL CURVE ADJUDICATION HAS LIMITATIONS; VISUAL EXAMINATION OF PCR CURVES FOR LOW SIGNAL OR ABERRANT CURVE GEOMETRY IS A CONSERVATIVE ASSESSMENT OF THE DATA. THE TEN ISSUES OCCURRED OVER A PERIOD OF TWO YEARS, USING THREE DIFFERENT KIT LOTS, SUGGESTING THAT THE ISSUE IS NOT LINKED TO SPECIFIC REAGENTS. AN INVESTIGATION THROUGH AN INSTRUMENT SERVICE TICKET IS ALSO ONGOING. THERE IS NO INDICATION OF A REAGENT ISSUE BASED ON THE ANALYSIS OF THE COMPLAINTS RECEIVED FOR DISCREPANT RESULTS ON BD MAX¿ ENTERIC PARASITE PANEL ASSAY LOTS 1138119, 2172819 AND 2110891. THE ROOT CAUSE WAS NOT IDENTIFIED. BD CANNOT CONFIRM THE COMPLAINT BASED ON THE INVESTIGATION THAT WAS PERFORMED. BD DID NOT INITIATE A CORRECTIVE AND PREVENTIVE ACTION PLAN (CAPA). BD QUALITY WILL CONTINUE TO MONITOR FOR TRENDS. H3 OTHER TEXT : SEE H.10.

Additional Manufacturer Narrative · 0

D2A: COMMON DEVICE NAME:GASTROINTESTINAL PATHOGEN PANEL MULTIPLEX NUCLEIC ACID-BASED ASSAY SYSTEM. INITIAL REPORTER PHONE: (B)(6). H.3. A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS ANTICIPATED BUT IS NOT COMPLETE. UPON COMPLETION, A SUPPLEMENTAL REPORT WILL BE FILED.

Description of Event or Problem · 0

REPORT 17 OF 20. IT WAS REPORTED THAT BD MAX¿ ENTERIC PARASITE PANEL DUE TO JAGGED CURVES SOMETIMES INSTRUMENT FLAGS POSITIVE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: DUE TO JAGGED CURVES, EPP SOMETIMES GIVES FALSE POSITIVE RESULTS MOSTLY FOR GIARDIA LAMBLIA (475 CHANNEL).

Description of Event or Problem · 0

REPORT 17 OF 20. IT WAS REPORTED THAT BD MAX¿ ENTERIC PARASITE PANEL DUE TO JAGGED CURVES SOMETIMES INSTRUMENT FLAGS POSITIVE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: DUE TO JAGGED CURVES, EPP SOMETIMES GIVES FALSE POSITIVE RESULTS MOSTLY FOR GIARDIA LAMBLIA (475 CHANNEL).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1275892 BD MAX¿ ENTERIC PARASITE PANEL SEE H.10 PCH GENEOHM SCIENCES CANADA, INC. (BD DIAGNOSTICS) 442960 2172819 00382904429607

Patients

Seq Age Sex Outcome Treatment
1 Unknown