FDA Adverse Event Malfunction Summary report: N

IMMAGE® 800 IMMUNOCHEMISTRY SYSTEM

MDR report key: 1913229 · Received December 2, 2010

Report

Report Number
2050012-2010-01478
Event Type
Malfunction
Date Received
December 2, 2010
Date of Event
November 3, 2010
Report Date
November 3, 2010
Manufacturer
BECKMAN COULTER, INC.
Product Code
JQX
PMA / PMN Number
K962294
Removal / Correction Number
Z-2887-2011
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CALIBRATION AND QC ARE ACCEPTABLE. NO SYSTEM ERROR WAS NOTED. SERVICE WAS NOT NEEDED FOR THIS EVENT AS THIS ISSUE IS REAGENT RELATED. INVESTIGATION INTO THE ROOT CAUSE OF THIS ISSUE IS ONGOING.

Additional Manufacturer Narrative · 1

(B)(4)

Description of Event or Problem · 1

...

Description of Event or Problem · 1

A CUSTOMER CONTACTED BECKMAN COULTER INC. (BCI) IN REGARDS TO FALSE POSITIVE RHEUMATOID FACTOR (RF) RESULTS GENERATED BY IMMAGE 800 IMMUNOCHEMISTRY SYSTEM. THE RESULTS WERE REPORTED OUT OF THE LABORATORY AND QUESTIONED BY PHYSICIANS. THERE WAS NO EFFECT TO THE PATIENT TREATMENTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 IMMAGE® 800 IMMUNOCHEMISTRY SYSTEM NEPHELOMETER, FOR CLINICAL USE JQX BECKMAN COULTER, INC. IMMAGE 800 NA

Patients

Seq Age Sex Outcome Treatment
1