FDA Adverse Event Malfunction Summary report: N

ELECSYS ANTI-TSHR

MDR report key: 20146069 · Received September 5, 2024

Report

Report Number
1823260-2024-02558
Event Type
Malfunction
Date Received
September 5, 2024
Date of Event
July 16, 2024
Report Date
January 14, 2025
Manufacturer
ROCHE DIAGNOSTICS
Product Code
JZO
UDI-DI
04015630939954
PMA / PMN Number
K080092
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

E1 INITIAL REPORTER FACILITY NAME: (B)(6). THE SAMPLES WERE REQUESTED FOR INVESTIGATION. THE INVESTIGATION IS ONGOING.

Additional Manufacturer Narrative · 0

THE PATIENT'S SAMPLE WAS TESTED. A COMPLEX INTERFERING FACTOR (AGAINST SA) AFFECTING DIFFERENT IMMUNOLOGICAL COMPONENTS OF THE ASSAYS WAS FOUND IN THE PATIENT SAMPLE DURING THE INVESTIGATION. PER PRODUCT LABELING: "IN RARE CASES, INTERFERENCE DUE TO EXTREMELY HIGH TITERS OF ANTIBODIES TO ANALYTE-SPECIFIC ANTIBODIES, STREPTAVIDIN OR RUTHENIUM CAN OCCUR. THESE EFFECTS ARE MINIMIZED BY SUITABLE TEST DESIGN. FOR DIAGNOSTIC PURPOSES, THE RESULTS SHOULD ALWAYS BE ASSESSED IN CONJUNCTION WITH THE PATIENT¿S MEDICAL HISTORY, CLINICAL EXAMINATION AND OTHER FINDINGS.". THE INVESTIGATION DID NOT IDENTIFY A PRODUCT PROBLEM.

Description of Event or Problem · 0

THERE WAS AN ALLEGATION OF QUESTIONABLE ELECSYS ANTI-TPO, ELECSYS ANTI-TG, ELECSYS ANTI-TSHR, AND ELECSYS TESTOSTERONE II RESULTS FOR 1 PATIENT ON A COBAS E 801 ANALYTICAL UNIT. THIS MEDWATCH COVERS THE ALLEGED RESULTS FOR THE ELECSYS ANTI-TSHR ASSAY. PLEASE REFER TO MEDWATCH WITH A1 - PATIENT IDENTIFIER = (B)(6) FOR THE ALLEGED ELECSYS ANTI-TG ASSAY RESULTS, MEDWATCH WITH A1 - PATIENT IDENTIFIER = (B)(6) FOR THE ALLEGED ELECSYS TESTOSTERONE II ASSAY RESULTS, AND MEDWATCH WITH A1 - PATIENT IDENTIFIER = (B)(6) FOR THE ALLEGED ELECSYS ANTI-TPO ASSAY RESULTS. REFER TO THE HIGHLIGHTED SECTION OF ATTACHMENT (B)(6) FOR PATIENT RESULTS. THE SAMPLES WERE REPEATED DUE TO THE RESULTS NOT MATCHING THE CLINICAL STATUS OF THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2036378 ELECSYS ANTI-TSHR ANTI-TSHR IMMUNOASSAY JZO ROCHE DIAGNOSTICS ASKU 04015630939954

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown CORTANCYL| LEVOTHYROX| NEOMERCAZOLE