FDA Adverse Event Malfunction Summary report: N

ALINITY HQ PROCESSING MODULE

MDR report key: 17959069 · Received October 18, 2023

Report

Report Number
2919069-2023-00042
Event Type
Malfunction
Date Received
October 18, 2023
Date of Event
October 2, 2023
Report Date
June 27, 2024
Manufacturer
ABBOTT LABORATORIES
Product Code
GKZ
UDI-DI
00380740138851
PMA / PMN Number
K220031
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE INVESTIGATION INCLUDED A REVIEW OF PRODUCT HISTORICAL DATA, PRODUCT LABELING AND TRACKING AND TRENDING FOR ALINITY HQ PROCESSING MODULE. A REVIEW WAS PERFORMED FOR ANY TRENDS AND ALL CUSTOMER COMPLAINTS RECEIVED FOR THIS ISSUE. THE REVIEW OF THIS DATA DID NOT IDENTIFY ANY TRENDS OR ABNORMAL COMPLAINT ACTIVITY. RETURN TESTING WAS NOT COMPLETED AS RETURNS WERE NOT AVAILABLE. A FLOW DETECTION FAULT ON WASTE TANK 2 WAS DETERMINED AND THE WASTE TANK 2 WAS REPLACED BY FIELD SERVICE, RESOLVING THE ISSUE OF FALSELY LOW RESULTS ON THE ALINITY HQ, SERIAL NUMBER (B)(6). A REVIEW OF THE PRODUCT HISTORICAL DATA DID NOT FIND A PRODUCT ISSUE RELATED TO THE COMPLAINT INCIDENT. A LABELING WAS FOUND TO BE ADEQUATE FOR THE COMPLAINT ISSUE. BASED ON THE AVAILABLE INFORMATION NO PRODUCT DEFICIENCY OF THE ALINITY HQ PROCESSING MODULE, LIST NUMBER 09P68, SERIAL NUMBER (B)(6), WAS IDENTIFIED. THE FOLLOWING SECTIONS HAVE BEEN CORRECTED TO REFLECT THE CURRENT CONTACT (B)(6).

Additional Manufacturer Narrative · 0

AN EVALUATION IS IN PROCESS. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN THE EVALUATION IS COMPLETE. COMPLETE INFORMATION FOR SECTION A1 PATIENT IDENTIFIER = SID (B)(6) AND SID (B)(6).

Additional Manufacturer Narrative · 0

CORRECTION WAS MADE TO FIELD D2B PRO CODE. THE INCORRECT CODE OF GRZ WAS CHANGED TO GKZ. THIS WAS A TYPOGRAPHICAL ERROR CORRECTION AND THERE IS NO FURTHER IMPACT TO THE SUBMISSION. ADDITIONAL INFORMATION PROVIDED IN SECTION D4 PRIMARY UDI NUMBER: (B)(4)

Description of Event or Problem · 0

THE CUSTOMER OBSERVED FALSELY DECREASED HEMOGLOBIN RESULTS ON THE ALINITY HQ, SERIAL NUMBER (B)(6), FOR TWO PATIENTS. THE RESULTS WERE NOT REPORTED OUT. THE SAMPLE WAS REPEATED ON ANOTHER ALINITY HQ, (B)(6) WITH EXPECTED RESULTS. THE FOLLOWING DATA FROM (B)(6) 2023 WAS PROVIDED: (B)(6): SID (B)(6) HGB = 7.60. SID (B)(6) HGB = 5.61. (B)(6): SID (B)(6) HGB = 12.8. SID (B)(6) HGB = 9.81 NO IMPACT TO PATIENT MANAGEMENT WAS REPORTED.

Description of Event or Problem · 0

THE CUSTOMER OBSERVED FALSELY DECREASED HEMOGLOBIN RESULTS ON THE ALINITY HQ, SERIAL NUMBER (B)(6) , FOR TWO PATIENTS. THE RESULTS WERE NOT REPORTED OUT. THE SAMPLE WAS REPEATED ON ANOTHER ALINITY HQ, HQ00503 WITH EXPECTED RESULTS. THE FOLLOWING DATA FROM (B)(6) 2023 WAS PROVIDED: HQ00501: SID (B)(6) HGB = 7.60. SID (B)(6) HGB = 5.61. HQ00503: SID (B)(6) HGB = 12.8. SID (B)(6) HGB = 9.81 NO IMPACT TO PATIENT MANAGEMENT WAS REPORTED.

Description of Event or Problem · 0

THE CUSTOMER OBSERVED FALSELY DECREASED HEMOGLOBIN RESULTS ON THE ALINITY HQ, SERIAL NUMBER (B)(6) , FOR TWO PATIENTS. THE RESULTS WERE NOT REPORTED OUT. THE SAMPLE WAS REPEATED ON ANOTHER ALINITY HQ, (B)(6) WITH EXPECTED RESULTS. THE FOLLOWING DATA FROM (B)(6) 2023 WAS PROVIDED: (B)(6) : SID (B)(6) HGB = 7.60, SID (B)(6) HGB = 5.61. (B)(6) : SID (B)(6) HGB = 12.8 SID (B)(6) HGB = 9.81 NO IMPACT TO PATIENT MANAGEMENT WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1227414 ALINITY HQ PROCESSING MODULE COUNTER, DIFFERENTIAL CELL GKZ ABBOTT LABORATORIES 00380740138851
176441 ALINITY HQ PROCESSING MODULE COUNTER, DIFFERENTIAL CELL GKZ ABBOTT LABORATORIES 00380740138851

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown ASSY, WASTE BTL, 1L, FLOAT LEVEL SWITCH, PPRO, H-3| ASSY, WASTE BTL, 1L, FLOAT LEVEL SWITCH, PPRO, H-3| ASSY, WASTE BTL, 1L, FLOAT LEVEL SWITCH, PPRO, H-3