FDA Adverse Event Malfunction Summary report: N

ORTHO PROVUE

MDR report key: 2111751 · Received June 2, 2011

Report

Report Number
1056600-2011-00052
Event Type
Malfunction
Date Received
June 2, 2011
Date of Event
May 9, 2011
Report Date
June 2, 2011
Manufacturer
MICROTYPING SYSTEMS
Product Code
KSZ
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

AN OCD FIELD ENGINEER (FE) ARRIVED AT THE CUSTOMER SITE AND REPLACED THE BROKEN SAMPLE TUBE SIDE SPRING ASSEMBLY. THE FE ALSO PERFORMED A PM AS PER CHECKLIST. THE CUSTOMER RAN AND PASSED QC. REPAIRS HAVE RETURNED THE INSTRUMENT TO EXPECTED OPERATION. (B)(4).

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT THE ORTHO PROVUE MISSED AN ANTIBODY THAT WAS DETECTED IN MANUAL GEL. NO ERRONEOUS RESULTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ORTHO PROVUE AUTOMATED BLOOD GROUPING & ANTIBODY TEST SYSTEM KSZ MICROTYPING SYSTEMS 3.1.1

Patients

Seq Age Sex Outcome Treatment
1