BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    UNICEL® DXI 600 ACCESS IMMUNOASSAY SYSTEM

    MDR report key: 2387963 · Received December 23, 2011

    Report

    Report Number
    2122870-2011-06438
    Event Type
    Malfunction
    Date Received
    December 23, 2011
    Date of Event
    September 30, 2011
    Report Date
    November 22, 2011
    Manufacturer
    BECKMAN COULTER INC.
    Product Code
    MMI
    PMA / PMN Number
    K023764
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NL
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    SAMPLE COLLECTION DEVICE AND CENTRIFUGATION INFORMATION WAS NOT PROVIDED. QC AND SYSTEM CHECK DATA WAS NOT PROVIDED. ACCESS ACCUTNI REAGENT LOT NUMBER WAS NOT PROVIDED A DEFINITIVE ROOT CAUSE FOR THIS EVENT HAS NOT BEEN DETERMINED TO DATE BASED ON THE SUPPLIED INFORMATION. NOTE: THIS REPORT CONTAINS INFORMATION ON THE CUSTOMER'S UNICEL DXI 600 ACCESS IMMUNOASSAY SYSTEM ONLY. THE INFORMATION ON THE CUSTOMER'S OTHER INSTRUMENT SYNCHRON LXI 725 CLINICAL SYSTEM IS LISTED BELOW: BRAND NAME: SYNCHRON LXI 725 CLINICAL SYSTEM, REFURBISHED. TYPE OF DEVICE: DISCRETE PHOTOMETRIC CHEMISTRY ANALYZER FOR CLINICAL USE. PRODUCT CODE: JJE. CATALOGUE NUMBER: A63254. SERIAL NUMBER: (B)(4). THE 510(K) NUMBER: K023049. DEVICE MANUFACTURE DATE: 09/11/2000. THE BELOW LISTED MDRS ARE BEING REPORTED FOR THE EVENTS ON DIFFERENT DATES AT THIS CUSTOMER SITE: 2122870-2011-06428, 2122870-2011-06429, 2122870-2011-06430, 2122870-2011-06431, 2122870-2011-06432, 2122870-2011-06433, 2122870-2011-06434, 2122870-2011-06435, 2122870-2011-06436, 2122870-2011-06437, 2122870-2011-06438, 2122870-2011-06439, 2122870-2011-06440, 2122870-2011-06441, 2122870-2011-06442, 2122870-2011-06443, 2122870-2011-06444, 2122870-2011-06445, 2122870-2011-06446, 2122870-2011-06447, 2122870-2011-06448. INITIALLY THIS REPORT WAS SUBMITTED ON (B)(4) 2011 WITHIN THE 30 DAY, HOWEVER, I RECEIVED A FAILURE NOTICE WITH THE ATTACHED NOTE. (B)(4).

    Description of Event or Problem · 1

    THE CUSTOMER CONTACTED BECKMAN COULTER INC. (BEC) TO REPORT OBTAINING REPRODUCIBLE ELEVATED TROPONIN I (ACCUTNI) RESULTS OVER A PERIOD OF (B)(6) 2011. THE CUSTOMER SWITCHED THE INSTRUMENT FROM SYNCHRON LXI 725 CLINICAL SYSTEM TO UNICEL DXI 600 ACCESS IMMUNOASSAY SYSTEM DURING THIS PERIOD, AND IT IS UNKNOWN WHICH RESULTS WERE OBTAINED FROM WHICH INSTRUMENT. THIS REPORT DOCUMENTS A RESULT, WITHIN THE RISK STRATIFICATION RANGE OF THE ASSAY , GENERATED ON (B)(6) 2011 FOR ONE (1) PATIENT. THE RESULT WAS REPORTED OUT OF THE LABORATORY, BUT DID NOT MATCH THE CLINICAL PICTURE OF THE PATIENT. IT IS UNKNOWN IF THERE WERE ANY CHANGE TO PATIENT TREATMENT IN CONNECTION TO THIS EVENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNICEL® DXI 600 ACCESS IMMUNOASSAY SYSTEM ANALYZER, CHEMISTRY (PHOTOMETRIC, DISCRETE), FOR CLINICAL USE MMI BECKMAN COULTER INC. DXI 600 N/A

    Patients

    Seq Age Sex Outcome Treatment
    1