FDA Adverse Event Malfunction Summary report: N

ALINITY I PROCESSING MODULE

MDR report key: 21784535 · Received April 7, 2025

Report

Report Number
3016438761-2025-00209
Event Type
Malfunction
Date Received
April 7, 2025
Date of Event
March 26, 2025
Report Date
April 24, 2025
Manufacturer
ABBOTT LABORATORIES
Product Code
JJE
UDI-DI
00380740137366
PMA / PMN Number
K170317
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

AN EVALUATION IS IN PROCESS. A FINAL REPORT WILL BE SUBMITTED WHEN THE EVALUATION IS COMPLETE. ALL AVAILABLE PATIENT INFORMATION WAS INCLUDED. ADDITIONAL PATIENT DETAILS ARE NOT AVAILABLE. THIS REPORT IS BEING FILED ON AN INTERNATIONAL PRODUCT, LIST NUMBER 03R65, THAT HAS A SIMILAR PRODUCT DISTRIBUTED IN THE US WITH THE SAME LIST NUMBER, AND A 510K/PMA/BLA NUMBER OF K170317.

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION IN SECTION D10 - CONCOMITANT PRODUCT AND SECTION H4 - DEVICE MFG DATE. THE FIELD SERVICE REPRESENTATIVE (FSR) INSPECTED THE INSTRUMENT AND PERFORMED MULTIPLE TROUBLE SHOOTING PROCEDURES. THE FSR FOUND PARTICLES/SEDIMENT IN THE BASE OF THE TRIGGER BOTTLE REF THE BULK SOLUTIONS, WHICH WAS CLEANED AND REFILLED. ADDITIONALLY, THE PUMP, BULK SOLUTION TRANSFER WAS REPLACED. THE PUMP, BULK SOLUTION TRANSFER WAS DEEMED THE LIKELY CAUSE FOR THE FALSE ELEVATED RESULT. THE MODULE FUNCTION WAS VERIFIED WITH A CONTROL RUN. RETURN TESTING WAS NOT COMPLETED AS RETURNS WERE NOT AVAILABLE. THE INSTRUMENT SERVICE HISTORY REVIEW FOR (B)(6) REVEALED NO ADDITIONAL SERVICE TICKETS ASSOCIATED WITH DISCREPANT/ERRATIC RESULTS. A REVIEW OF TRACKING AND TRENDING FOR THE ALINITY I PROCESSING MODULE DID NOT IDENTIFY AN INCREASE IN COMPLAINT ACTIVITY. A REVIEW OF TRACKING AND TRENDING FOR THE PUMP, BULK SOLUTION TRANSFER DID NOT IDENTIFY AN INCREASE IN COMPLAINT ACTIVITY. REVIEW OF THE MANUFACTURING DOCUMENTATION DID NOT IDENTIFY ANY NON-CONFORMANCES OR POTENTIAL NON-CONFORMANCES ASSOCIATED WITH THE COMPLAINT ISSUE. LABELING WAS REVIEWED AND FOUND TO ADEQUATELY ADDRESS THE ISSUE UNDER REVIEW. BASED ON THE INVESTIGATION, NO SYSTEMIC ISSUE OR DEFICIENCY OF THE ALINITY I PROCESSING MODULE FOR SERIAL (B)(6) OR THE PUMP, BULK SOLUTION TRANSFER WERE IDENTIFIED.

Description of Event or Problem · 0

THE CUSTOMER OBSERVED A FALSELY ELEVATED ALINITY I FREE T4 RESULT GENERATED FOR A PATIENT SAMPLE. THE FOLLOWING DATA WAS PROVIDED (CUSTOMER¿S REFERENCE RANGE 9.0-19.0 PMOL/L): (B)(6) 2025 SAMPLE ID (B)(6) INITIAL RESULT = 24.7 PMOL/L, (B)(6) 2025 REPEAT RESULT = 13.7 PMOL/L, REPEAT RESULT ON ANOTHER ANALYZER (B)(6) = 13.86 PMOL/L. ADDITIONAL RESULTS PROVIDED: FSH RESULT = 4.641 IU/L. TSH RESULT = 0.757 MIU/L. SHBG RESULT = 51.12 NMOL/L. LH RESULT = 3.227 IU/L. TESTO RESULT = <0.450 NMOL/L, (B)(6) 2025 REPEAT RESULT = 0.477 NMOL/L. NO IMPACT TO PATIENT MANAGEMENT WAS REPORTED.

Description of Event or Problem · 0

THE CUSTOMER OBSERVED A FALSELY ELEVATED ALINITY I FREE T4 RESULT GENERATED FOR A PATIENT SAMPLE. THE FOLLOWING DATA WAS PROVIDED (CUSTOMER¿S REFERENCE RANGE 9.0-19.0 PMOL/L): (B)(6) 2025 SAMPLE ID (B)(6) INITIAL RESULT = 24.7 PMOL/L, (B)(6) 2025 REPEAT RESULT = 13.7 PMOL/L, REPEAT RESULT ON ANOTHER ANALYZER (B)(6) = 13.86 PMOL/L. ADDITIONAL RESULTS PROVIDED: FSH RESULT = 4.641 IU/L. TSH RESULT = 0.757 MIU/L. SHBG RESULT = 51.12 NMOL/L. LH RESULT = 3.227 IU/L. TESTO RESULT = <0.450 NMOL/L, (B)(6) 2025 REPEAT RESULT = 0.477 NMOL/L. NO IMPACT TO PATIENT MANAGEMENT WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1459256 ALINITY I PROCESSING MODULE ANALYZER, CHEMISTRY (PHOTOMETRIC, DISCRETE), FOR CLINICAL USE JJE ABBOTT LABORATORIES 00380740137366

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown ALNTY I FREE T4 1200T, 07P70-30, 70400UD00| ALNTY I FREE T4 1200T, 07P70-30, 70400UD00| PUMP, BULK SOLUTION TRANSFER, A-30111949-01, UNKNO