FDA Adverse Event Malfunction Summary report: N

VITROS IMMUNODIAGNOSTIC PRODUCTS TROPONIN I ES REAGENT PACK

MDR report key: 2122219 · Received June 13, 2011

Report

Report Number
3007111389-2011-00079
Event Type
Malfunction
Date Received
June 13, 2011
Date of Event
May 15, 2011
Report Date
June 13, 2011
Manufacturer
ORTHO CLINICAL DIAGNOSTICS
Product Code
MMI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE INVESTIGATION DETERMINED THAT NON-REPRODUCIBLE, HIGHER THAN EXPECTED VITROS TROP I ES RESULTS WERE OBTAINED FROM MULTIPLE PATIENT SAMPLES PROCESSED ON THE VITROS ECIQ IMMUNODIAGNOSTIC SYSTEM. NO REPAIRS HAVE BEEN MADE TO THE INSTRUMENT AT THIS TIME. THE INVESTIGATION DID NOT DETERMINED WHETHER THE SAMPLES IN QUESTION WERE PROCESSED IN ACCORDANCE WITH THE TUBE MANUFACTURER'S RECOMMENDATIONS. CELLULAR DEBRIS, DUE TO POOR SAMPLE PREPARATION, MAY HAVE BEEN PRESENT IN THE AFFECTED SAMPLES, ALTHOUGH THIS COULD NOT BE CONFIRMED. A DEFINITIVE ROOT CAUSE COULD NOT BE DETERMINED. HOWEVER, PRE-ANALYTICAL SAMPLE PROCESSING OR AN INSTRUMENT RELATED EVENT CANNOT BE RULED OUT AS CONTRIBUTING FACTORS. THE ROOT CAUSE OF THIS EVENT IS UNKNOWN.

Description of Event or Problem · 1

THE CUSTOMER OBTAINED MULTIPLE NON-REPRODUCIBLE HIGHER THAN EXPECTED VITROS TROP I ES RESULTS FROM PATIENT SAMPLES (PATIENT 1"0.080 NG/ML" COMPARED TO "0" AND PATIENT 2 "0.070 NG/ML COMPARED TO 0.014 NG/ML) WHEN PROCESSING ON THE VITROS ECI IMMUNODIAGNOSTIC SYSTEM. BIASED RESULTS OF THE DIRECTION AND MAGNITUDE OBSERVED MAY LEAD TO INAPPROPRIATE PHYSICIAN ACTION. THE AFFECTED RESULTS WERE NOT REPORTED OUT OF THE LABORATORY. THERE WAS NO REPORT OF PATIENT HARM AS A RESULT OF THIS EVENT. (B)(4). NOTE: THIS IS ONE OF TWO 3500A FORMS BEING SUBMITTED FOR THIS EVENT AS TWO DEVICES WERE INVOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VITROS IMMUNODIAGNOSTIC PRODUCTS TROPONIN I ES REAGENT PACK IN VITRO DIAGNOSTIC MMI ORTHO CLINICAL DIAGNOSTICS 0640

Patients

Seq Age Sex Outcome Treatment
1