FDA Adverse Event Malfunction Summary report: N

ACCESS 2 IMMUNOASSAY SYSTEM

MDR report key: 2172085 · Received June 15, 2011

Report

Report Number
2122870-2011-01777
Event Type
Malfunction
Date Received
June 15, 2011
Date of Event
February 3, 2009
Report Date
February 4, 2009
Manufacturer
BECKMAN COULTER, INC.
Product Code
JJE
PMA / PMN Number
K922823/A007
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE CUSTOMER CANCELLED THE SERVICE CALL. THE FIELD SERVICE ENGINEER (FSE) DID NOT EVALUATE THE DEVICE. QUALITY CONTROL (QC) DATA WAS REVIEWED AND IT WAS RECOVERING WITHIN +/- 2 STANDARD DEVIATION (SD) PRIOR TO AND ON THE DATE OF THE EVENT. NO DEFINITIVE CAUSE COULD BE DETERMINED FOR THIS EVENT. THIS IS ONE OF THREE SEPARATE MDR REPORTS RELATED TO THREE PT EVENTS ASSOCIATED WITH A SINGLE MALFUNCTION REPORT. REF MDR#S: 2122870-2011-01777, 01778, 01883 FOR ALL EVENT. THIS REPORTABLE EVENT WAS IDENTIFIED DURING A RETROSPECTIVE REVIEW OF COMPLAINTS CONDUCTED BETWEEN (B)(4), 2008 AND (B)(4), 2010 FOR ADD'L REPORTABLE EVENTS.

Description of Event or Problem · 1

THE CUSTOMER CONTACTED BECKMAN COULTER, INC. (BCI) ON (B)(6) 2009 IN REGARDS TO ERRONEOUSLY ELEVATED ACCUTNI RESULTS GENERATED ON THE ACCESS 2 IMMUNOASSAY SYSTEM FOR THREE PTS. THE PT SAMPLES WERE RETESTED AND THE RESULTS RECOVERED WITHIN THE NORMAL REFERENCE RANGE. THE INITIAL ERRONEOUSLY ELEVATED RESULTS WERE REPORTED OUTSIDE THE LAB. IT IS NOT KNOWN IF THERE WAS ANY CHANGE TO THE PT TREATMENT. THERE IS NO INDICATION OF AN ADVERSE EVENT OR INDICATION OF ANY MEDICAL INTERVENTION TO PREVENT SERIOUS INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACCESS 2 IMMUNOASSAY SYSTEM JJE BECKMAN COULTER, INC. NA NA

Patients

Seq Age Sex Outcome Treatment
1 63 YR ACCESS ACCUTNI