FDA Adverse Event Malfunction Summary report: Y

NEO IRIS

MDR report key: 20611495 · Received November 5, 2024

Report

Report Number
1034569-2024-00018
Event Type
Malfunction
Date Received
November 5, 2024
Report Date
January 7, 2025
Manufacturer
IMMUCOR, INC.
Product Code
KSZ
UDI-DI
10888234002321
PMA / PMN Number
BK180243
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

NO COMMON SPECIFIC ROOT CAUSE OR DEFECT WAS IDENTIFIED. THE CONCLUSION(S) CODE(S) REPORTED HEREIN ARE ASSIGNED ACCORDING TO THE FACTS PRESENTED BY THE AFFECTED CUSTOMER AND IMMUCOR'S ASSESSMENT AND INVESTIGATION OF THOSE FACTS. WHEN POSSIBLE, IMMUCOR ATTEMPTS TO OBTAIN THE ACTUAL SAMPLES AND REAGENTS INVOLVED; RETENTION REAGENTS OF THE SAME LOT THAT WAS INVOLVED IN THE EVENT MAY BE USED DURING THE INVESTIGATION IF INDICATED. ALSO, WHEN POSSIBLE, IMMUCOR USES REMOTE ACCESS TO REVIEW THE RELEVANT DATA ARCHIVED ON THE INSTRUMENT. THE EVENTS REPORTED ON THIS QUARTERLY MALFUNCTION SUMMARY REPORT ARE LIMITED TO THOSE IN WHICH NO PATIENT HARM OCCURRED, AND NO DESIGN DEFECT (OR OTHER SYSTEMIC PROBLEM) WAS IDENTIFIED. THERE IS NO SPECIFIC ACTION THAT USERS ARE EXPECTED TO TAKE TO MITIGATE THE REPORTED DEVICE FAILURE/MALFUNCTION OTHER THAN TO ENSURE THAT PREVENTATIVE MAINTENANCE IS PERFORMED AS INDICATED IN THE INSTRUMENT INSTRUCTIONS. IMMUCOR WILL CONTINUE TO TRACK AND TREND PERFORMANCE AND OPERATIONAL ISSUES SUCH AS DESCRIBED IN THIS QUARTERLY MALFUNCTION SUMMARY REPORT. THE INITIAL DATE THAT THE CUSTOMER REPORTED THE COMPLAINT ASSOCIATED WITH PR#1040070 (PREVIOUSLY SUBMITTED AS MAY 20, 2024) WAS INCORRECT AND WAS DUE TO A TRANSCRIPTION ERROR WHEN COMPLETING THE FORM 3500A; THE CORRECTED DATE IS AUGUST 20, 2024. THE INITIAL DATE THAT THE CUSTOMER REPORTED THE COMPLAINT ASSOCIATED WITH PR#(B)(4) (PREVIOUSLY SUBMITTED AS MAY 26, 2024) WAS INCORRECT AND WAS DUE TO A TRANSCRIPTION ERROR WHEN COMPLETING THE FORM 3500A; THE CORRECTED DATE IS AUGUST 26, 2024. ONE ADDITIONAL EVENT (PR#(B)(4) WAS DETERMINED TO BE REPORTABLE AFTER THE INITIAL QUARTERLY MALFUNCTION SUMMARY REPORT HAD BEEN SUBMITTED; THIS EVENT WAS INITIALLY ASSESSED AS NOT REPORTABLE, BUT UPON SUBSEQUENT REVIEW WAS DETERMINED TO BE REPORTABLE. THIS CORRECTED QUARTERLY MALFUNCTION SUMMARY REPORT HAS BEEN SUBMITTED IN RESPONSE TO THE AGENCY'S DECEMBER 27, 2024 EMAIL (GEN2400785-S002: REQUEST OF CORRECTIONS OF MDRS SUBMITTED IN SUMMARY FORMAT). MDR REPORT NUMBER 1034569-2024-00018 IS AN INADVERTENTLY SUBMITTED DUPLICATE OF MDR REPORT NUMBER 1034569-2024-00015.

Additional Manufacturer Narrative · 0

NO COMMON SPECIFIC ROOT CAUSE OR DEFECT WAS IDENTIFIED. THE CONCLUSION(S) CODE(S) REPORTED HEREIN ARE ASSIGNED ACCORDING TO THE FACTS PRESENTED BY THE AFFECTED CUSTOMER AND IMMUCOR'S ASSESSMENT AND INVESTIGATION OF THOSE FACTS. WHEN POSSIBLE, IMMUCOR ATTEMPTS TO OBTAIN THE ACTUAL SAMPLES AND REAGENTS INVOLVED; RETENTION REAGENTS OF THE SAME LOT THAT WAS INVOLVED IN THE EVENT MAY BE USED DURING THE INVESTIGATION IF INDICATED. ALSO, WHEN POSSIBLE, IMMUCOR USES REMOTE ACCESS TO REVIEW THE RELEVANT DATA ARCHIVED ON THE INSTRUMENT. THE EVENTS REPORTED ON THIS QUARTERLY MALFUNCTION SUMMARY REPORT ARE LIMITED TO THOSE IN WHICH NO PATIENT HARM OCCURRED, AND NO DESIGN DEFECT (OR OTHER SYSTEMIC PROBLEM) WAS IDENTIFIED. THERE IS NO SPECIFIC ACTION THAT USERS ARE EXPECTED TO TAKE TO MITIGATE THE REPORTED DEVICE FAILURE/MALFUNCTION OTHER THAN TO ENSURE THAT PREVENTATIVE MAINTENANCE IS PERFORMED AS INDICATED IN THE INSTRUMENT INSTRUCTIONS. IMMUCOR WILL CONTINUE TO TRACK AND TREND PERFORMANCE AND OPERATIONAL ISSUES SUCH AS DESCRIBED IN THIS QUARTERLY MALFUNCTION SUMMARY REPORT.

Description of Event or Problem · 0

A REVIEW INDICATED THAT IN EIGHT (8) EVENTS FOR SEVEN (7) DONOR SAMPLES AND TWO (2) PATIENT SAMPLES TESTED USING THE NEO IRIS AUTOMATED BLOOD BANK SYSTEM, A MALFUNCTION OCCURRED RESULTING IN THE INSTRUMENT PRODUCING INCORRECT RESULTS. A REVIEW OF QUARTERLY EVENTS INDICATED THAT SEVEN (7) DONOR SAMPLES AND TWO (2) PATIENT SAMPLES TESTED ON THE NEO IRIS AUTOMATED BLOOD BANK SYSTEM PRODUCED INACCURATE RESULTS: RH MISTYPE FOR ONE (1) DONOR SAMPLE; ABO MISTYPE FOR SIX (6) DONOR SAMPLES AND ONE (1) PATIENT SAMPLE; AND A MISSED ANTIBODY FOR ONE (1) PATIENT SAMPLE.

Description of Event or Problem · 0

A REVIEW INDICATED THAT IN EIGHT (8) EVENTS FOR SEVEN (7) DONOR SAMPLES AND TWO (2) PATIENT SAMPLES TESTED USING THE NEO IRIS AUTOMATED BLOOD BANK SYSTEM, A MALFUNCTION OCCURRED RESULTING IN THE INSTRUMENT PRODUCING INCORRECT RESULTS. A REVIEW OF QUARTERLY EVENTS INDICATED THAT SEVEN (7) DONOR SAMPLES AND TWO (2) PATIENT SAMPLES TESTED ON THE NEO IRIS AUTOMATED BLOOD BANK SYSTEM PRODUCED INACCURATE RESULTS: RH MISTYPE FOR ONE (1) DONOR SAMPLE; ABO MISTYPE FOR SIX (6) DONOR SAMPLES AND ONE (1) PATIENT SAMPLE; AND A MISSED ANTIBODY FOR ONE (1) PATIENT SAMPLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1727258 NEO IRIS AUTOMATED BLOOD BANK SYSTEM KSZ IMMUCOR, INC. 10888234002321

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown