BEUDAMED
    FDA Adverse Event Injury Summary report: N

    RHEUMATOID FACTOR TEST SYSTEM

    MDR report key: 2140106 · Received June 25, 2011

    Report

    Report Number
    2050012-2011-02662
    Event Type
    Injury
    Date Received
    June 25, 2011
    Date of Event
    May 24, 2011
    Report Date
    May 25, 2011
    Manufacturer
    BECKMAN COULTER INC.
    Product Code
    DHR
    PMA / PMN Number
    N/A
    Removal / Correction Number
    2050012-06/24/2011-024R
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    SAMPLE PREPARATION AND HANDLING INFORMATION ASSOCIATED WITH THIS EVENT WERE NOT SUPPLIED BY THE CUSTOMER. CALIBRATION AND QC RESULTS FAXED BY CUSTOMER APPEAR TO BE ACCEPTABLE. THE CUSTOMER HAS NOT REPORTED ANY OTHER CHEMISTRY ISSUES OR SYSTEM ERRORS. A CUSTOMER NOTIFICATION LETTER WAS DISTRIBUTED IN ASSOCIATION WITH THIS RHEUMATOID FACTOR LOT. THIS IS A REAGENT ISSUE.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THEY OBTAINED FALSELY POSITIVE RHEUMATOID FACTOR (RF) ASSAY RESULT WHICH WERE GENERATED FROM A UNICEL DXC 600 PRO SYNCHRON CLINICAL SYSTEM IN ASSOCIATION WITH A SPECIFIC RHEUMATOID FACTOR (RF) REAGENT LOT. THE RESULTS WERE NOT PROVIDED. NO REPEAT OR CONFIRMATORY TESTING RESULTS WERE PROVIDED BY THE CUSTOMER. HENCE IT CANNOT BE VERIFIED THAT THE INITIAL RESULT WAS, IN FACT, ERRONEOUS. THE INITIAL, POSITIVE RESULT WAS RELEASED FROM THE LABORATORY; HOWEVER, THE CUSTOMER INDICATED THAT THEY DID NOT RECEIVE ANY REPORTS OF PATIENT TREATMENT BEING AFFECTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RHEUMATOID FACTOR TEST SYSTEM RHEUMATOID FACTOR DHR BECKMAN COULTER INC. RHEUMATOID FACTORS M010568

    Patients

    Seq Age Sex Outcome Treatment
    1