FDA Adverse Event Other Summary report: N

HCG COMBO MERIDIAN IMMUNOCARD STAT!

MDR report key: 2593864 · Received May 25, 2012

Report

Report Number
2030538-2012-00002
Event Type
Other
Date Received
May 25, 2012
Date of Event
May 23, 2012
Report Date
May 25, 2012
Manufacturer
SEKISUI DIAGNOSTICS, LLC
Product Code
JHI
PMA / PMN Number
K043385
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

CUSTOMER COMPLAINED OF A FALSE NEGATIVE URINE RESULT WHICH WAS CONFIRMED (AFTER IUD PLACEMENT) BY A BETA SERUM QUANTITATIVE RESULT OF 92 MIU/ML. PRODUCT IFU STATES THAT RESULTS SHOULD BE CONFIRMED WITH A QUANTITATIVE TEST PRIOR TO PERFORMANCE OF ANY CRITICAL MEDICAL PROCEDURE. THE IUD WAS REMOVED AND THE PT RELEASED FROM CARE. CUSTOMER REPORTED PT SUBSEQUENTLY MISCARRIED.

Description of Event or Problem · 1

INFO WAS RECEIVED FROM CUSTOMER THAT A PT MISCARRIED. PT HAD RECEIVED AN IUD AFTER A FALSE NEGATIVE HCG QUALITATIVE TEST. QUANTITATIVE TEST (PERFORMED AFTER IUD HAD BEEN INSERTED) INDICATED THE PT WAS PREGNANT. IUD WAS REMOVED AT THAT TIME AND PT WAS RELEASED FROM CARE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HCG COMBO MERIDIAN IMMUNOCARD STAT! JHI (HCG TEST) JHI SEKISUI DIAGNOSTICS, LLC 755425 08111279

Patients

Seq Age Sex Outcome Treatment
1 Other