FDA Adverse Event Malfunction Summary report: N

ALINITY I FREE PSA REAGENT KIT

MDR report key: 21350056 · Received February 10, 2025

Report

Report Number
3008344661-2025-00014
Event Type
Malfunction
Date Received
February 10, 2025
Date of Event
January 17, 2025
Report Date
May 1, 2025
Manufacturer
ABBOTT IRELAND DIAGNOSTICS DIVISION
Product Code
MTG
UDI-DI
00380740130329
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KS
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS REPORT IS BEING FILED ON AN INTERNATIONAL PRODUCT, LIST NUMBER 07P93-20 THAT HAS A SIMILAR PRODUCT DISTRIBUTED IN THE US, LIST NUMBER 07P93-21/31, WITH 510K/PMA/BLA NUMBER P980007. A1 PATIENT IDENTIFIER: COMPLETE LIST OF SAMPLE ID'S ARE (B)(6). AN EVALUATION IS IN PROCESS. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN THE EVALUATION IS COMPLETE.

Additional Manufacturer Narrative · 0

THE COMPLAINT INVESTIGATION INCLUDED A REVIEW OF DATA AND INFORMATION PROVIDED BY THE CUSTOMER, SEARCH FOR SIMILAR COMPLAINTS, TICKET TRENDING REVIEW, LABELING REVIEW, DEVICE HISTORY RECORD REVIEW, AND IN HOUSE TESTING OF A RETAINED REAGENT KIT LOT 65532FZ00. RETURN TESTING WAS NOT COMPLETED AS RETURNS WERE NOT AVAILABLE. DATA AND INFORMATION PROVIDED BY THE CUSTOMER WERE REVIEWED AND SUPPORT THE COMPLAINT ISSUE WITHOUT INDICATION FOR ANY ADDITIONAL ISSUE. THE TICKET SEARCH BY LOT INDICATES THAT THE REAGENT LOT PERFORMS AS EXPECTED FOR THIS PRODUCT. THE TICKET TRENDING REVIEW DID NOT IDENTIFY AN INCREASE IN COMPLAINT ACTIVITY. DEVICE HISTORY REVIEW DID NOT IDENTIFY ANY NON-CONFORMANCES OR DEVIATIONS WITH THE COMPLAINT LOT. IN-HOUSE TESTING WAS COMPLETED USING PANELS WHICH MIMIC PATIENT SAMPLES USING AN IN-HOUSE RETAINED KIT. ALL SPECIFICATIONS WERE MET INDICATING THE LOT IS PERFORMING ACCEPTABLY. LABELING WAS REVIEWED AND SUFFICIENTLY ADDRESSES THE CUSTOMER¿S ISSUE. BASED ON THE INVESTIGATION, NO SYSTEMIC ISSUE OR DEFICIENCY OF THE ALINITY I FREE PSA REAGENT LOT 65532FZ00 WAS IDENTIFIED.

Description of Event or Problem · 0

THE CUSTOMER OBSERVED FALSELY DECREASED ALINITY I FREE PSA AND PROVIDED THE FOLLOWING DATA FOR A MALE PATIENT WITH A HISTORY OF PROSTATIC HYPERPLASIA, PRESENTING WITH URINARY TRACT INFECTION AND HEMATURIA. SAMPLE ID (B)(6) WAS DRAWN ON (B)(6) 2025: ON THE BECKMAN PLATFORM THE FREE PSA WAS >19.00. THE SAMPLE WAS REPEATED ON THE ALINITY PLATFORM ON (B)(6) 2025 AND THE FREE PSA WAS 0.07. A SECOND SAMPLE (SAMPLE ID (B)(6) WAS DRAWN ON (B)(6)2025: ON THE BECKMAN PLATFORM THE FREE PSA WAS 5.359. THE SAMPLE WAS REPEATED ON THE ALINITY PLATFORM ON (B)(6) 2025 AND THE FREE PSA WAS 6.528. PATIENT HISTORICAL VALUES: ON (B)(6) 2024, FREE PSA WAS 1.891 (PLATFORM UNKNOWN). PER THE CUSTOMER DISCREPANT RESULTS WERE NOT REPORTED OUT TO THE MEDICAL PROVIDER. THERE WAS NO REPORTED IMPACT TO PATIENT MANAGEMENT.

Description of Event or Problem · 0

THE CUSTOMER OBSERVED FALSELY DECREASED ALINITY I FREE PSA AND PROVIDED THE FOLLOWING DATA FOR A MALE PATIENT WITH A HISTORY OF PROSTATIC HYPERPLASIA, PRESENTING WITH URINARY TRACT INFECTION AND HEMATURIA. SAMPLE ID (B)(6) WAS DRAWN ON (B)(6) 2025: ON THE BECKMAN PLATFORM THE FREE PSA WAS >19.00. THE SAMPLE WAS REPEATED ON THE ALINITY PLATFORM ON (B)(6) 2025 AND THE FREE PSA WAS 0.07 A SECOND SAMPLE (SAMPLE ID (B)(6)) WAS DRAWN ON (B)(6) 2025: ON THE BECKMAN PLATFORM THE FREE PSA WAS 5.359. THE SAMPLE WAS REPEATED ON THE ALINITY PLATFORM ON (B)(6) 2025 AND THE FREE PSA WAS 6.528. PATIENT HISTORICAL VALUES: ON (B)(6) 2024, FREE PSA WAS 1.891 (PLATFORM UNKNOWN). PER THE CUSTOMER DISCREPANT RESULTS WERE NOT REPORTED OUT TO THE MEDICAL PROVIDER. THERE WAS NO REPORTED IMPACT TO PATIENT MANAGEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
959268 ALINITY I FREE PSA REAGENT KIT TOTAL, PROSTATE SPECIFIC AG (NONCOMPLEXED/COMPLEXED) FOR DET OF PROSTATE CANCER MTG ABBOTT IRELAND DIAGNOSTICS DIVISION 65532FZ00 00380740130329

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown ALNTY I PROCESSING MODU, 03R65-01, (B)(6)| ALNTY I PROCESSING MODU, 03R65-01, (B)(6)