FDA Adverse Event Malfunction Summary report: N

COBAS 6000 E601 MODULE

MDR report key: 2969374 · Received February 20, 2013

Report

Report Number
1823260-2013-01049
Event Type
Malfunction
Date Received
February 20, 2013
Date of Event
February 4, 2013
Report Date
February 27, 2013
Manufacturer
ROCHE DIAGNOSTICS
Product Code
JLW
PMA / PMN Number
K060373
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THIS EVENT OCCURRED IN (B)(6).

Additional Manufacturer Narrative · 1

THREE SAMPLES WERE RETURNED FOR INVESTIGATION. THE PRESENCE OF MACRO TSH WAS IDENTIFIED IN THE PATIENT'S SAMPLES. THIS INTERFERENCE IS DOCUMENTED IN THE PACKAGE INSERT.

Description of Event or Problem · 1

THE CUSTOMER ALLEGED THEY RECEIVED QUESTIONABLE THYROTROPIN (TSH) RESULTS FOR ONE PATIENT ON THEIR E601 ANALYZER. THE PATIENT'S INITIAL TSH RESULT WAS 98.53 MUI/L AND IT WAS REPORTED OUTSIDE THE LABORATORY. THE SAMPLE WAS SENT TO ANOTHER LABORATORY AND TESTED ON A CENTAUR ANALYZER. THE RESULT WAS 14.09 MUI/L. THE BIOLOGIST IS QUESTIONING THE HIGH TSH RESULT AS THE PATIENT HAD NO CLINICAL SIGNS OF HYPOTHYROIDISM. THE PATIENT WAS NOT ADVERSELY AFFECTED. THE TSH REAGENT LOT NUMBER WAS 170904 AND THE EXPIRATION DATE WAS NOT PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
73712 COBAS 6000 E601 MODULE IMMUNOCHEMISTRY ANALYZER JLW ROCHE DIAGNOSTICS NA NA

Patients

Seq Age Sex Outcome Treatment
1 009 YR SPASFON| SMECTA