FDA Adverse Event Malfunction Summary report: N

SYNCHRON® LX RHEUMATOID FACTOR (RF REAGENT)

MDR report key: 2060391 · Received April 15, 2011

Report

Report Number
2050012-2011-01158
Event Type
Malfunction
Date Received
April 15, 2011
Date of Event
March 14, 2011
Report Date
March 16, 2011
Manufacturer
BECKMAN COULTER INC.
Product Code
DHR
PMA / PMN Number
K971788
Removal / Correction Number
Z-2887-2011
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

NO SAMPLE INFORMATION WAS PROVIDED BY THE CUSTOMER. NO SYSTEM ISSUES WERE NOTED. THIS IS A REAGENT RELATED ISSUE. THE ISSUE WAS RESOLVED BY CHANGING REAGENTS LOTS.

Additional Manufacturer Narrative · 1

(B)(4)

Description of Event or Problem · 1

...

Description of Event or Problem · 1

A CUSTOMER CONTACTED BECKMAN COULTER INC. (BCI) IN REGARDS TO OBTAINING FALSELY POSITIVE RHEUMATOID FACTOR (RF) RESULTS THAT WERE GENERATED BY THE IMMAGE 800 IMMUNOCHEMISTRY SYSTEM. NO ERRONEOUS RESULTS WERE REPORTED OUT OF THE LABORATORY. THE PATIENT RESULTS WERE REPEATED USING A NEW REAGENT LOT. PATIENT TREATMENT WAS NOT AFFECTED IN THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYNCHRON® LX RHEUMATOID FACTOR (RF REAGENT) SYSTEM, TEST, RHEUMATOID FACTOR DHR BECKMAN COULTER INC. RF REAGENT M911529

Patients

Seq Age Sex Outcome Treatment
1