FDA Adverse Event Malfunction Summary report: N

MEDLINE URINALYSIS REAGENT STRIPS

MDR report key: 22153205 · Received June 5, 2025

Report

Report Number
2531491-2025-00122
Event Type
Malfunction
Date Received
June 5, 2025
Date of Event
March 27, 2025
Report Date
August 6, 2025
Manufacturer
ACON LABORATORIES, INC.
Product Code
JIO
PMA / PMN Number
K061559
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KY, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

IN THIS FOLLOW-UP REPORT, THE FOLLOWING INFORMATION IS DIFFERENT THAN THE INITIAL REPORT. B4: DATE OF THIS REPORT. G6: TYPE OF REPORT. H2: IF FOLLOW-UP, WHAT TYPE? H6: ADVERSE EVENT PROBLEM. THE FINAL INVESTIGATION YIELDED THE FOLLOWING CONCLUSION: BATCH RECORDS FOR FINAL PRODUCT MANUFACTURE AND QC RECORD FOR 98124030001 WERE REVIEWED AND NO ABNORMAL ISSUE WAS FOUND IN MANUFACTURING PROCESS, TECHNICAL TESTING AND QUALITY CONTROL INSPECTION, AND THE MANUFACTURING PROCESS IS COMPLIED WITH DMR. THE TEST RESULTS OF RETENTION SAMPLES FROM 98124030001 MET THE QC CRITERIA. IN HOUSE TESTING WAS PERFORMED WITH RETAINED STRIPS, NEGATIVE AND POSITIVE CONTROLS, SIEMENS MULTISTIX 10SG AND 20 CLINICAL SAMPLES. THE BLOOD PAD SHOWS CORRECT PERFORMANCE WHEN TESTED WITH URINE CONTROLS AND CLINICAL URINE SAMPLES. WE HAVE NOT FOUND THE COMPLAINT ISSUE WHEN COMPARING WITH SIEMENS MULTISTIX 10SG STRIPS. THE BLOOD PAD SHOWS THE SAME AND CORRECT VALUE WHEN TEST BY VISUAL AND BY ANALYZER THE ROOT CAUSE COULD NOT BE DETERMINED.

Description of Event or Problem · 0

ON (B)(6) 2025 THE CUSTOMER NOTIFIED MEDLINE SHARING THAT A URINE SAMPLE WAS TESTED WITH AN EXTERNAL METHOD AND BLOOD WAS FOUND TO BE IN THE URINE, BUT THE BLOOD WAS NOT DETECTED WITH THE MANUAL URINE TEST STRIP.

Description of Event or Problem · 0

ON (B)(6) 2025 THE CUSTOMER NOTIFIED MEDLINE SHARING THAT A URINE SAMPLE WAS TESTED WITH AN EXTERNAL METHOD AND BLOOD WAS FOUND TO BE IN THE URINE, BUT THE BLOOD WAS NOT DETECTED WITH THE MANUAL URINE TEST STRIP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
603692 MEDLINE URINALYSIS REAGENT STRIPS URINALYSIS REAGENT STRIPS JIO ACON LABORATORIES, INC. 98124030001

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown