FDA Adverse Event Malfunction Summary report: N

COBAS 6000 C501 MODULE

MDR report key: 1994024 · Received February 16, 2011

Report

Report Number
1823260-2011-00874
Event Type
Malfunction
Date Received
February 16, 2011
Date of Event
January 28, 2011
Report Date
February 16, 2011
Manufacturer
ROCHE DIAGNOSTICS
Product Code
CEM
PMA / PMN Number
K060373
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Description of Event or Problem · 1

THE CUSTOMER ALLEGED APPROXIMATELY 12 QUESTIONABLE ION SELECTIVE ELECTRODE (ISE) SODIUM RESULTS ON THE COBAS 6000 C501 MODULE. THE CUSTOMER STATED THE ISSUE HAD BEEN ONGOING SINCE (B)(6) 2010. THE CUSTOMER COULD ONLY PROVIDE COMPARISONS FOR 6 SAMPLES, 5 OF WHICH WERE DISCREPANT. FOR SAMPLE 1 THE INITIAL SODIUM AS 116 MMOL/L. THE REPEAT SODIUM, ON THE SAME ANALYZER, WAS 126 MMOL/L. FOR SAMPLE 2 THE INITIAL SODIUM AS 131 MMOL/L. THE REPEAT SODIUM, ON THE SAME ANALYZER, WAS 140 MMOL/L. FOR SAMPLE 3 THE INITIAL SODIUM AS 128 MMOL/L. THE REPEAT SODIUM, ON THE SAME ANALYZER, WAS 137 MMOL/L. FOR SAMPLE 4 THE INITIAL SODIUM AS 131 MMOL/L. THE REPEAT SODIUM, ON THE SAME ANALYZER, WAS 141 MMOL/L. FOR SAMPLE 5 THE INITIAL SODIUM AS 139 MMOL/L. THE REPEAT SODIUM, ON THE SAME ANALYZER, WAS 147 MMOL/L. THE INITIAL RESULTS WERE REPORTED OUTSIDE THE LABORATORY. NO PATIENTS WERE ADVERSELY AFFECTED BY THE EVENT. THE CUSTOMER DID NOT PROVIDE THE SODIUM ELECTRODE LOT NUMBER. THE FIELD SERVICE REPRESENTATIVE DETERMINED THE EVENT WAS CAUSED BY A FLUIDICS FAILURE DUE TO DEFECTIVE ISE SIPPER SYRINGE SEALS. HE REPLACED THE SEALS. THE CUSTOMER PERFORMED CALIBRATION, QUALITY CONTROLS, AND PRECISION TESTING, WHICH WERE ACCEPTABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COBAS 6000 C501 MODULE CLINICAL CHEMISTRY ANALYZER CEM ROCHE DIAGNOSTICS NA NA

Patients

Seq Age Sex Outcome Treatment
1