FDA Adverse Event Malfunction Summary report: N

DIRECT CHECK QUALITY CONTROL

MDR report key: 2572446 · Received May 8, 2012

Report

Report Number
2250033-2012-00005
Event Type
Malfunction
Date Received
May 8, 2012
Date of Event
January 1, 2012
Report Date
April 11, 2012
Manufacturer
INTERNATIONAL TECHNIDYNE CORP.
Product Code
GGN
PMA / PMN Number
K944691
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THIS MDR SUBMITTED (B)(4) 2012. (B)(4). METHOD - ACTUAL DEVICE NOT EVALUATED. A CAPA WAS COMPLETED FOR DIRECTCHECK STARTING WITH LOTS MANUFACTURED IN (B)(4) 2011. EACH DIRECTCHECK PACKAGE INCLUDES AN INSERT CONTAINING A PICTURE DEMONSTRATING THE PREFERRED TECHNIQUE TO USE DURING ACTIVATION OF THE DIRECTCHECK ASSEMBLY. IN ADDITION, THE ITC WEBSITE INCLUDES A VIDEO WHICH ILLUSTRATES THE PREFERRED TECHNIQUE TO USE DURING ACTIVATION OF THE DIRECTCHEK ASSEMBLY. NO PRODUCT RETURNED. RESULT - NO RESULTS AVAILABLE SINCE NO EVAL PERFORMED. CONCLUSION - HUMAN FACTORS ISSUE. THE DIRECTCHECK PROTECTIVE SLEEVE IS PROVIDED AS A MEANS TO REDUCE PROBABILITY OF CUTS. THE INSTRUCTIONS FOR USE INDICATES USE OF PROTECTIVE SLEEVE IS REQUIRED WHEN CONTROL VIALS ARE ACTIVATED. ITC HAS REQUESTED ALL DATA REQUIRED FOR FORM 3500A.

Description of Event or Problem · 1

HEALTHCARE PROFESSIONAL REPORTS END USER WAS INJURED ON RIGHT THUMB FROM PIECE OF GLASS WHEN ACTIVATING THE DIRECT CHECK QUALITY CONTROL. END USER WAS NOT USING THE PROTECTIVE SLEEVE AT THE TIME OF THE INCIDENT. STANDARD FIRST AID WAS ADMINISTERED. NO REPORT OF SERIOUS INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DIRECT CHECK QUALITY CONTROL GGN INTERNATIONAL TECHNIDYNE CORP. DCJPT-A B1DPA002

Patients

Seq Age Sex Outcome Treatment
1