FDA Adverse Event Malfunction Summary report: N

GALILEO

MDR report key: 1935723 · Received December 22, 2010

Report

Report Number
1034569-2010-00260
Event Type
Malfunction
Date Received
December 22, 2010
Date of Event
November 24, 2010
Report Date
December 22, 2010
Manufacturer
IMMUCOR
Product Code
KSZ
PMA / PMN Number
BK040013
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
MEDICAL TECHNOLOGIST

Narratives

Additional Manufacturer Narrative · 1

REVIEW OF REACTIONS STRENGTHS CELL 1 - HAD A NEGATIVE RESULT WITH A REACTION STRENGTH OF 11 AND CELL 2 HAD A NEGATIVE RESULT WITH A REACTION STRENGTH OF 18. BASED ON REVIEW OF SAMPLE DATA THIS ISSUE APPEARS TO BE SAMPLE RELATED.

Description of Event or Problem · 1

CUSTOMER REPORTED UNEXPECTED NEGATIVE RESULTS WHEN TESTING A SAMPLE WITH A KNOWN ANTI-E ON A 2 CELL SCREENING ASSAY ON THE GALILEO.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GALILEO BLOOD BANK ANALYZER KSZ IMMUCOR

Patients

Seq Age Sex Outcome Treatment
1 88 YR