FDA Adverse Event Malfunction Summary report: N

OLYMPUS AU400 CLINICAL CHEMISTRY ANALYZER (AU481-03 ISE)

MDR report key: 2300213 · Received October 19, 2011

Report

Report Number
2050012-2011-06422
Event Type
Malfunction
Date Received
October 19, 2011
Date of Event
September 6, 2011
Report Date
September 19, 2011
Manufacturer
BECKMAN COULTER MISHIMAK.K.
Product Code
JJE
PMA / PMN Number
K981743
Removal / Correction Number
N/A
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

PATIENT INFORMATION WERE NOT PROVIDED. SAMPLE WAS SERUM. THE CUSTOMER PREVIOUSLY REPORTED THE SAME ISSUE IN MDR # 2050012-2011-04388 AND PATIENT SAMPLES WERE SENT TO CO. CLARE FOR TESTING. NO ABNORMALITIES WERE OBSERVED IN THE REACTION PROFILES OF THE SAMPLES WHICH WERE SENT. BECKMAN COULTER, INC. COMPLETED SYSTEM CHECKS AND HARDWARE UPGRADES FOR THE CUSTOMER AS OF (B)(4) 2011. THE INVESTIGATION FOR THIS ISSUE IS STILL ON GOING. THIS REPORT IS RELATED TO THE FOLLOWING MDRS THAT ARE BEING REPORTED ON DIFFERENT DATES FOR THE SIMILAR EVENTS THAT OCCURRED AT THIS CUSTOMER SITE: 2050012-2011-06418, 2050012-2011-06419, 2050012-2011-06420, 2050012-2011-06421, 2050012-2011-06423.

Description of Event or Problem · 1

A CUSTOMER CONTACTED BECKMAN COULTER, INC. (BEC) TO REPORT MULTIPLE INCORRECT CREATININE PATIENT SAMPLE RESULTS THAT WERE GENERATED ON THE AU481-03E WITH ISE CHEMISTRY ANALYZER, USED IN CONJUNCTION WITH CREATININE ENZYMATIC R1 AND R2 REAGENT (LOT 1625) OVER THE COURSE OF SIX (6) DAYS ((B)(6) 2011). THE SAMPLES EXHIBITED AN ABNORMAL REACTION PROFILE WITHOUT FLAGGING. THIS REPORT DOCUMENTS THE PATIENT RESULTS GENERATED ON (B)(6) 2011. THE SAMPLES WERE RERUN AND GAVE EXPECTED RESULTS WITH A NORMAL REACTION PROFILE. THE ORIGINAL CREATININE RESULTS WERE NOT REPORTED OUT OF THE LABORATORY. THE CUSTOMER DID NOT REPORT AN EFFECT TO PATIENT AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 OLYMPUS AU400 CLINICAL CHEMISTRY ANALYZER (AU481-03 ISE) ANALYZER, CHEMISTRY (PHOTOMETRIC, DISCRETE), FOR CLINICAL USE JJE BECKMAN COULTER MISHIMAK.K. AU481-03 ISE NA

Patients

Seq Age Sex Outcome Treatment
1