FDA Adverse Event Malfunction Summary report: N

ALINITY I TSH REAGENT KIT

MDR report key: 16911074 · Received May 11, 2023

Report

Report Number
3005094123-2023-00124
Event Type
Malfunction
Date Received
May 11, 2023
Date of Event
February 4, 2022
Report Date
August 2, 2023
Manufacturer
ABBOTT IRELAND DIAGNOSTICS DIVISION
Product Code
JLW
UDI-DI
00380740131159
PMA / PMN Number
K983442
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE COMPLAINT INVESTIGATION REGARDING FALSELY DECREASED ALINITY I TSH REAGENT LOT 45295UD00 INCLUDED A REVIEW OF DATA AND INFORMATION PROVIDED BY THE CUSTOMER, SEARCH FOR SIMILAR COMPLAINTS, TICKET TRENDING REVIEW, LABELING REVIEW, DEVICE HISTORY RECORD REVIEW, AND FIELD DATA REVIEW. RETURN TESTING WAS NOT COMPLETED AS RETURNS WERE NOT YET AVAILABLE. THE TICKET SEARCH BY LOT INDICATES THAT THE REAGENT LOT PERFORMS AS EXPECTED FOR THIS PRODUCT. TICKET AND TRENDING REVIEW DID NOT IDENTIFY ANY TRENDS. DEVICE HISTORY RECORD REVIEW DID NOT IDENTIFY ANY RELATED NON-CONFORMANCES OR DEVIATIONS. THE OVERALL PERFORMANCE OF THE ALINITY I TSH REAGENT WAS REVIEWED USING FIELD DATA FROM CUSTOMERS WORLDWIDE. THE REVIEW OF FIELD DATA DETERMINED THE MEDIAN PATIENT RESULTS FOR LOT 45295UD00 ARE COMPARABLE WITH OTHER LOTS IN THE FIELD, INDICATING NO SYSTEMIC ISSUE FOR THE LOT. A LABELING REVIEW DETERMINED PRODUCT LABELING PROVIDES ADEQUATE INFORMATION REGARDING THE CUSTOMER ISSUE. BASED ON THE INVESTIGATION, NO SYSTEMIC ISSUE OR DEFICIENCY WITH THE ALINITY I TSH REAGENT LOT 45295UD00 WAS IDENTIFIED.

Additional Manufacturer Narrative · 0

A1 PATIENT IDENTIFIER: COMPLETE SAMPLE ID'S (B)(6). AN EVALUATION IS IN PROCESS. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN THE EVALUATION IS COMPLETE. ALL AVAILABLE PATIENT INFORMATION WAS INCLUDED. ADDITIONAL PATIENT DETAILS ARE NOT AVAILABLE.

Description of Event or Problem · 0

THE CUSTOMER OBSERVED FALSELY DEPRESSED RESULTS OF ALINITY I TSH FOR 1 PATIENT AND PROVIDED THE FOLLOWING DATA (REFERENCE RANGE IS 0.3 ¿ 5 MU/L). ON 4-FEB-22 SAMPLE ID (B)(6) TSH (MU/L) RESULT WAS 0.15, FREE T4 (PMOL/L) RESULT WAS 12.2, FREE T3 (PMOL/L) RESULT WAS 4.3. ON 22-APR-22 SAMPLE ID (B)(6) TSH (MU/L) RESULT WAS 0.133, FREE T4 (PMOL/L) RESULT WAS 13.3, FREE T3 (PMOL/L) RESULT WAS 4.7. ON 16-JUN-22 SAMPLE ID (B)(6) TSH (MU/L) RESULT WAS 0.18, FREE T4 (PMOL/L) RESULT WAS 13.4, FREE T3 (PMOL/L) RESULT WAS 5. ON 21-OCT-22 SAMPLE ID (B)(6) TSH (MU/L) RESULT WAS 0.163, FREE T4 (PMOL/L) RESULT WAS 11.7, FREE T3 (PMOL/L) RESULT WAS 4.3. ON 7-DEC-22 SAMPLE ID (B)(6) TSH (MU/L) RESULT WAS 0.121, FREE T4 (PMOL/L) RESULT WAS 13.5, FREE T3 (PMOL/L) RESULT WAS NOT TESTED. ON 30-MAR-23 SAMPLE ID (B)(6) TSH (MU/L) RESULT WAS0.146, FREE T4 (PMOL/L) RESULT WAS 15.8, FREE T3 (PMOL/L) RESULT WAS 4.8. THE PATIENT HAD SAMPLES SENT TO OTHER LABORATORIES AND GENERATED RESULTS ON DIFFERENT ANALYZER PLATFORMS: ROCHE PLATFORM (REFERENCE RANGE IS 0.27 ¿ 4.2 MU/L AND NOT DATES PROVIDED) TSH (MU/L) RESULT WAS 0.952, FREE T4 (PMOL/L) RESULT WAS 19.7, FREE T3 (PMOL/L) RESULT WAS 5.16. TSH (MU/L) RESULT WAS 0.982, FREE T4 (PMOL/L) RESULT WAS 19.7, FREE T3 (PMOL/L) RESULT WAS 5.16 BECKMAN PLATFORM: (NO REFERENCE RANGE PROVIDED). TSH (MU/L) RESULT WAS 0.885, FREE T4 (PMOL/L) RESULT WAS 16.7, FREE T3 (PMOL/L) RESULT WAS 4.89 DATE: FROM 4 APR 2023. THE CUSTOMER FURTHER REPORTED THAT HAMA ANTIBODIES WERE NEGATIVE, HETEROPHILIC ANTIBODIES WERE NOT TESTED, AND SAMPLES FROM THE PATIENT WERE VISUALLY UNREMARKABLE (NOT ICTERIC, NO LIPEMIA OR HEMOLYSIS). THE CUSTOMER DOES BELIEVE THAT A PATIENT SPECIFIC INTERFERENCE IS UNLIKELY. THERE WAS NO REPORTED IMPACT TO PATIENT MANAGEMENT REPORTED.

Description of Event or Problem · 0

THE CUSTOMER OBSERVED FALSELY DEPRESSED RESULTS OF ALINITY I TSH FOR 1 PATIENT AND PROVIDED THE FOLLOWING DATA (REFERENCE RANGE IS 0.3 ¿ 5 MU/L). ON (B)(6) 2022 SAMPLE ID (B)(6) TSH (MU/L) RESULT WAS 0.15, FREE T4 (PMOL/L) RESULT WAS 12.2, FREE T3 (PMOL/L) RESULT WAS 4.3. ON (B)(6) 2022 SAMPLE ID (B)(6) TSH (MU/L) RESULT WAS 0.133, FREE T4 (PMOL/L) RESULT WAS 13.3, FREE T3 (PMOL/L) RESULT WAS 4.7. ON (B)(6) 2022 SAMPLE ID (B)(6) TSH (MU/L) RESULT WAS 0.18, FREE T4 (PMOL/L) RESULT WAS 13.4, FREE T3 (PMOL/L) RESULT WAS 5. ON (B)(6) 2022 SAMPLE ID (B)(6) TSH (MU/L) RESULT WAS 0.163, FREE T4 (PMOL/L) RESULT WAS 11.7, FREE T3 (PMOL/L) RESULT WAS 4.3. ON (B)(6) 2022 SAMPLE ID (B)(6) TSH (MU/L) RESULT WAS 0.121, FREE T4 (PMOL/L) RESULT WAS 13.5, FREE T3 (PMOL/L) RESULT WAS NOT TESTED. ON (B)(6) 2023 SAMPLE ID (B)(6)TSH (MU/L) RESULT WAS0.146, FREE T4 (PMOL/L) RESULT WAS 15.8, FREE T3 (PMOL/L) RESULT WAS 4.8. THE PATIENT HAD SAMPLES SENT TO OTHER LABORATORIES AND GENERATED RESULTS ON DIFFERENT ANALYZER PLATFORMS: ROCHE PLATFORM (REFERENCE RANGE IS 0.27 ¿ 4.2 MU/L AND NOT DATES PROVIDED). TSH (MU/L) RESULT WAS 0.952, FREE T4 (PMOL/L) RESULT WAS 19.7, FREE T3 (PMOL/L) RESULT WAS 5.16. TSH (MU/L) RESULT WAS 0.982, FREE T4 (PMOL/L) RESULT WAS 19.7, FREE T3 (PMOL/L) RESULT WAS 5.16. BECKMAN PLATFORM: (NO REFERENCE RANGE PROVIDED). TSH (MU/L) RESULT WAS 0.885, FREE T4 (PMOL/L) RESULT WAS 16.7, FREE T3 (PMOL/L) RESULT WAS 4.89. DATE: FROM (B)(6) 2023. THE CUSTOMER FURTHER REPORTED THAT HAMA ANTIBODIES WERE NEGATIVE, HETEROPHILIC ANTIBODIES WERE NOT TESTED, AND SAMPLES FROM THE PATIENT WERE VISUALLY UNREMARKABLE (NOT ICTERIC, NO LIPEMIA OR HEMOLYSIS). THE CUSTOMER DOES BELIEVE THAT A PATIENT SPECIFIC INTERFERENCE IS UNLIKELY. THERE WAS NO REPORTED IMPACT TO PATIENT MANAGEMENT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1164904 ALINITY I TSH REAGENT KIT RADIOIMMUNOASSAY, THYROID-STIMULATING HORMONE JLW ABBOTT IRELAND DIAGNOSTICS DIVISION 07P4830 45295UD00 00380740131159

Patients

Seq Age Sex Outcome Treatment
1 Unknown ALNTY I PROCESSING MODU, 03R65-01, AI01774| ALNTY I PROCESSING MODU, 03R65-01, AI01774