FDA Adverse Event Malfunction Summary report: N

0.8% RESOLVE PANEL A

MDR report key: 2491774 · Received March 14, 2012

Report

Report Number
2250051-2012-00041
Event Type
Malfunction
Date Received
March 14, 2012
Date of Event
February 28, 2012
Report Date
March 14, 2012
Manufacturer
ORTHO CLINICAL DIAGNOSTICS
Product Code
KSZ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

OCD PERFORMED RETAINED TESTING AND A BATCH RECORD REVIEW. SATISFACTORY RESULTS WERE OBSERVED. (B)(4).

Description of Event or Problem · 1

CUSTOMER REPORTED THAT A PATIENT SAMPLE WITH A POSITIVE ANTIBODY SCREEN DID NOT REACT WITH VRA165 CELL 4. ALL OTHER D+ CELLS REACTED 1-2+. PATIENT HAD A HISTORY OF ANTI-D. SAMPLE WAS RETESTED AND NO REACTIVITY WAS OBSERVED WITH CELL 4. PATIENT DID NOT REQUIRE ANY TRANSFUSIONS. CUSTOMER STATED THAT QC WAS ACCEPTABLE. CUSTOMER STATED THAT CELL 4 WAS TESTED WITH KNOWN ANTI-D QC MATERIAL AND A 2+ POSITIVE REACTION WAS OBSERVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 0.8% RESOLVE PANEL A REAGENT RED BLOOD CELLS KSZ ORTHO CLINICAL DIAGNOSTICS VRA165

Patients

Seq Age Sex Outcome Treatment
1