FDA Adverse Event Other Summary report: N

IMMULITE HCG ASSAY

MDR report key: 2803288 · Received June 1, 2009

Report

Report Number
2017183-2009-00046
Event Type
Other
Date Received
June 1, 2009
Date of Event
April 13, 2009
Report Date
April 16, 2009
Manufacturer
SIEMENS HEALTHCARE DIAGNOSTICS
Product Code
DHA
PMA / PMN Number
K990222
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ANALYSIS OF THE INSTRUMENT AND INSTRUMENT DATA INDICATE THAT THERE ARE NO KNOWN CAUSE FOR THE DISCORDANT HCG RESULT. NO FURTHER EVALUATION OF THE DEVICE IS REQUIRED. THE INSTRUMENT IS PERFORMING WITHIN SPECIFICATIONS.

Description of Event or Problem · 1

A POSITIVE IMMULITE HCG RESULT WAS OBTAINED ON A PATIENT SAMPLE. THE ORIGINAL SAMPLE WAS RETESTED AND THE HCG RESULT WAS STILL POSITIVE. AN ULTRA SOUND AND URINE DIPSTICK CONFIRMED NO PREGNANCY. PATIENT TREATMENT WAS NOT ALTERED AND THERE WAS NO REPORT OF ADVERSE HEALTH CONSEQUENCES DUE TO THE DISCORDANT HCG RESULT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 IMMULITE HCG ASSAY HCG IMMUNOASSAY DHA SIEMENS HEALTHCARE DIAGNOSTICS NA 333

Patients

Seq Age Sex Outcome Treatment
1