FDA Adverse Event Malfunction Summary report: N

ELECSYS ANTI-TSHR

MDR report key: 19827536 · Received July 25, 2024

Report

Report Number
1823260-2024-02158
Event Type
Malfunction
Date Received
July 25, 2024
Date of Event
July 1, 2024
Report Date
September 3, 2024
Manufacturer
ROCHE DIAGNOSTICS
Product Code
JZO
UDI-DI
07613336160305
PMA / PMN Number
K193313
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE COBAS E411 RACK SERIAL NUMBER WAS (B)(6). THE INVESTIGATION IS ONGOING.

Additional Manufacturer Narrative · 0

THE INVESTIGATION DID NOT IDENTIFY A PRODUCT PROBLEM. THE CAUSE OF THE EVENT COULD NOT BE DETERMINED.

Description of Event or Problem · 0

WE RECEIVED AN ALLEGATION ABOUT DISCREPANT RESULTS FOR 1 PATIENT SAMPLE TESTED WITH ELECSYS ANTI-TSHR ASSAY ON A COBAS E411 IMMUNOASSAY ANALYZER (RACK SYSTEM). INITIAL RESULT: 37.98 IU/L. THE INITIAL RESULT DID NOT MATCH THE PATIENT'S CLINICAL HISTORY AND THE SAME SAMPLE WAS THEN REPEATED ON THE SAME ANALYZER ON (B)(6) 2024. REPEAT RESULT: 1.75 IU/L. NO QUESTIONABLE RESULT WAS REPORTED OUTSIDE THE LABORATORY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
358613 ELECSYS ANTI-TSHR THYROID AUTOANTIBODY IMMUNOLOGICAL TEST SYSTEM JZO ROCHE DIAGNOSTICS 76925802 07613336160305

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown