FDA Adverse Event Malfunction Summary report: N

IMMAGE RHEUMATOID FACTOR (RF)

MDR report key: 2438297 · Received February 3, 2012

Report

Report Number
2050012-2012-00330
Event Type
Malfunction
Date Received
February 3, 2012
Date of Event
December 30, 2011
Report Date
January 13, 2012
Manufacturer
BECKMAN COULTER, INC.
Product Code
DHR
PMA / PMN Number
K963048
Removal / Correction Number
2050012-01/26/2012-003C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THIS ISSUE IS CURRENTLY UNDER INVESTIGATION.

Additional Manufacturer Narrative · 1

CUSTOMER RECEIVED A NEW LOT OF RHEUMATOID FACTOR, AND BECKMAN COULTER CONSIDERS THAT NO FURTHER INVESTIGATION IS REQUIRED FOR THIS EVENT.

Description of Event or Problem · 1

CUSTOMER REPORTED ERRONEOUS HIGH TEST RESULTS WERE OBTAINED WHEN USING THE IMMAGE RHEUMATOID FACTOR (RF) ON THE IMMAGE 800 IMMUNOCHEMISTRY SYSTEM. CUSTOMER REPORTED AN INCREASE IN THE NUMBER OF RF POSITIVE PATIENT RESULTS, WITH MOST OF THE RESULTS RECOVERING A VALUE SLIGHTLY ABOVE 20 IU/ML. CALIBRATION AND QUALITY CONTROL DATA WERE EVALUATED AND ARE ACCEPTABLE. THE ERRONEOUS HIGH TEST RESULTS WERE REPORTED OUT OF THE LABORATORY. THERE WERE NO REPORTS OF DEATH, SERIOUS INJURY OR AFFECT TO PATIENT MANAGEMENT ASSOCIATED WITH THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 IMMAGE RHEUMATOID FACTOR (RF) SYSTEM, TEST, RHEUMATOID FACTOR DHR BECKMAN COULTER, INC. IMMAGE RF M101865

Patients

Seq Age Sex Outcome Treatment
1 IMMAGE 800 IMMUNOCHEMISTRY SYSTEM