FDA Adverse Event Malfunction Summary report: N

ADVIA CENTAUR XP

MDR report key: 2942671 · Received February 4, 2013

Report

Report Number
2432235-2012-00270
Event Type
Malfunction
Date Received
February 4, 2013
Date of Event
August 15, 2011
Report Date
August 8, 2012
Manufacturer
SIEMENS HEALTHCARE DIAGNOSTICS, INC.
Product Code
JJE
PMA / PMN Number
K971418
Removal / Correction Number
2432235-08/16/2012-001-C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

A SIEMENS HEALTHCARE DIAGNOSTICS FSE (FIELD SERVICE ENGINEER) WAS DISPATCHED TO THE CUSTOMER SITE FOR INSTRUMENT EVALUATION. THE FSE CHECKED FOR BLEACH CONTAMINATION AT EACH FLUID LINE AND CONFIRMED BLEACH RESIDUAL AT THE RESUSPENSION PORT. THE FSE REPLACED 3 WAY AND 2 WAY VALVES, CHECKED INSTRUMENT AND VACUUM CALIBRATION. SIEMENS INFORMED THE CUSTOMER TO PRIME THE RESUSPENSION PORT BEFORE RUNNING QC. A FIELD CORRECTION WAS IMPLEMENTED. NO FURTHER EVALUATION OF THE DEVICE IS NECESSARY. THE SYSTEM IS PERFORMING WITHIN SPECIFICATIONS. NOTE: (B)(4). SIEMENS DID NOT SEE THIS MDR POSTED ON THE FDA WEBSITE (MAUDE) AND IS RESENDING THIS MDR.

Description of Event or Problem · 1

AFTER A DAILY CLEANING PROCEDURE (DCP), THE CUSTOMER STATED CA 19-9A QC RESULTS WERE LOW. THIS ISSUE WAS OBSERVED ON TWO SYSTEMS AT THIS CUSTOMER SITE. BASED ON THE INFORMATION PROVIDED THERE WERE NO INCORRECT PATIENT RESULTS ASSOCIATED WITH THIS COMPLAINT. SIEMENS PROVIDED A TEMPORARY WORKAROUND TO THE CUSTOMER AT THE TIME OF THE EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
47105 ADVIA CENTAUR XP IMMUNOASSAY ANALYZER JJE SIEMENS HEALTHCARE DIAGNOSTICS, INC. ADVIA CENTAUR XP N/A

Patients

Seq Age Sex Outcome Treatment
1