FDA Adverse Event Malfunction Summary report: N

HENRY SCHEIN ONE STEP+ HCG URINE CASSETTE TEST

MDR report key: 3050308 · Received March 7, 2013

Report

Report Number
2027969-2013-00199
Event Type
Malfunction
Date Received
March 7, 2013
Date of Event
February 4, 2013
Report Date
March 7, 2013
Manufacturer
ALERE SAN DIEGO, INC.
Product Code
JHI
PMA / PMN Number
K993317
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CT, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING.

Description of Event or Problem · 1

CUSTOMER ALLEGED RECEIVING 2 FALSE NEGATIVE RESULTS. CUSTOMER WAS ONLY ABLE TO PROVIDE DATA ON ONE PT; PT VISIT ON (B)(6) 2013 ((B)(6) 2012) NEGATIVE PREGNANCY TEST IN OFFICE AFTER 3 MINS TIME, HCG QUANT TOTAL AT LAB OF 1740 DRAWN AT 11:20 AM. PT SPECIMEN WAS REPORTED AS FRESH. INTERNAL AND EXTERNAL CONTROLS WERE REPORTED AS FINE. NO PT SAMPLES WERE AVAILABLE FOR INSPECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
98461 HENRY SCHEIN ONE STEP+ HCG URINE CASSETTE TEST HCG PREGNANCY JHI ALERE SAN DIEGO, INC. FHC-102-KHS25 HCG2030271

Patients

Seq Age Sex Outcome Treatment
1