FDA Adverse Event Malfunction Summary report: N

UNICEL® DXI 800 ACCESS® IMMUNOASSAY ANALYZER

MDR report key: 1964455 · Received January 20, 2011

Report

Report Number
2122870-2011-00077
Event Type
Malfunction
Date Received
January 20, 2011
Date of Event
December 8, 2010
Report Date
December 22, 2010
Manufacturer
BECKMAN COULTER, INC.
Product Code
JJE
PMA / PMN Number
K023764
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SW
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE SAMPLE WAS LITHIUM HEPARIN PLASMA. IT IS UNKNOWN IF THE DILUTIONS WERE MADE ON BOARD OR MANUALLY. SERVICE WAS NOT DISPATCHED FOR THIS EVENT. A CLEAR ROOT CAUSE FOR THE EVENT HAS NOT BEEN DETERMINED TO DATE.

Description of Event or Problem · 1

A CUSTOMER CONTACTED BECKMAN COULTER INC (BCI) IN REGARDS TO ELEVATED FERRITIN RESULTS ABOVE THE NORMAL REFERENCE RANGE GENERATED BY UNICEL DXI 800 ACCESS IMMUNOASSAY ANALYZER FOR ONE PATIENT. THE RESULT WAS REPORTED OUT OF THE LABORATORY, AND QUESTIONED BY THE PHYSICIAN. SUBSEQUENT TESTING WITH DILUTIONS AND AN ALTERNATE METHOD PRODUCED EVEN HIGHER RESULTS. THE CUSTOMER DID NOT RECEIVE ANY REPORT OF PATIENT INJURY REQUIRING MEDICAL INTERVENTION OR CHANGE TO PATIENT TREATMENT ATTRIBUTED OR CONNECTED TO THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNICEL® DXI 800 ACCESS® IMMUNOASSAY ANALYZER DISCRETE PHOTOMETRIC CHEMISTRY ANALYZER JJE BECKMAN COULTER, INC. DXI 800 NA

Patients

Seq Age Sex Outcome Treatment
1 9 YR