FDA Adverse Event Malfunction Summary report: N

RAPIDPOINT 500E BLOOD GAS SYSTEM

MDR report key: 22825140 · Received August 18, 2025

Report

Report Number
3002637618-2025-00064
Event Type
Malfunction
Date Received
August 18, 2025
Date of Event
August 4, 2025
Report Date
September 16, 2025
Manufacturer
SIEMENS HEALTHCARE DIAGNOSTICS INC.
Product Code
CHL
UDI-DI
00630414286174
PMA / PMN Number
K192240
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ASSESSMENT OF THE INSTRUMENT DATA PROVIDED BY THE CUSTOMER SHOWED ¿SODIUM SENSOR INTERFERENT DETECTED¿ MESSAGES ON THE DATE OF THE EVENT, BEFORE THE REPORTED SAMPLE MEASUREMENTS. THIS IS AN INDICATION OF NA+ SENSOR EXPOSURE TO QUATERNARY AMMONIUM COMPOUNDS (QACS) SUCH AS BENZALKONIUM FOUND IN MANY SKIN DISINFECTANTS OR EXTERIOR CLEANERS. PER THE CUSTOMER BULLETINS AND THE RAPIDPOINT 500 OPERATOR¿S GUIDE IT IS RECOMMENDED NOT TO USE ANY SKIN DISINFECTING PRODUCTS AND/OR EXTERIOR DISINFECTANTS THAT CONTAIN QUATERNARY AMMONIUM COMPOUNDS (QAC) AS THEY ARE KNOWN INTERFERENTS TO THE RP500/500E NA+ SENSOR BY POTENTIALLY IMPACTING THE SENSOR AND ITS¿ PERFORMANCE AND SHOULD BE AVOIDED. THE SOURCE CONTAINING QAC WAS NOT DISCLOSED TO SIEMENS HOWEVER IT HAS BEEN RECOMMENDED THAT THEY IDENTIFY AND CEASE USE OF THE SOURCE. THE ROOT CAUSE FOR THE DISCREPANT LOW NA+ RESULT WAS DUE TO USER ERROR FROM THE MOMENTARY INSTABILITY OF THE NA+ SENSOR FROM AN INTERFERENT WHEN THE SAMPLES IN QUESTION WERE RUN. THE MEASUREMENT CARTRIDGE WAS CHANGED AND THE INSTRUMENT IS PERFORMING AS INTENDED AND IS CURRENTLY OPERATIONAL.

Additional Manufacturer Narrative · 0

THE CUSTOMER REPLACED THE MEASUREMENT CARTRIDGE AND THE SYSTEM IS OPERATIONAL. THE CUSTOMER PROVIDED INSTRUMENT FILES FOR FURTHER INVESTIGATION. INVESTIGATION IS UNDERWAY. THE CAUSE OF THIS EVENT IS UNKNOWN.

Description of Event or Problem · 0

THE CUSTOMER REPORTED A DISCREPANT LOW NA+ RESULT ON A PATIENT SAMPLE WHEN COMPARED TO A REPEAT ON A LABORATORY ANALYZER. THERE IS NO REPORT OF INJURY DUE TO THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1679289 RAPIDPOINT 500E BLOOD GAS SYSTEM RAPIDPOINT 500E BLOOD GAS SYSTEM CHL SIEMENS HEALTHCARE DIAGNOSTICS INC. 00630414286174

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown