FDA Adverse Event Other Summary report: N

DCA VANTAGE ANALYZER

MDR report key: 3071016 · Received April 11, 2013

Report

Report Number
1217157-2013-00057
Event Type
Other
Date Received
April 11, 2013
Date of Event
March 27, 2013
Report Date
March 28, 2013
Manufacturer
SIEMENS HEALTHCARE DIAGNOSTICS INC.
Product Code
CGX
PMA / PMN Number
K071466
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VT, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE CAUSE FOR THE DISCORDANT HBA1C RESULT IS UNKNOWN.

Description of Event or Problem · 1

CUSTOMER REPORTED DISCORDANT HEMOGLOBIN A1C RESULTS. A FINGER STICK ON THE DCA RESULTED IN AN 8.6 WHEREAS A REFERENCE LAB RESULT WAS 7.4. THERE WAS NO REPORT OR INJURY FOR THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
155346 DCA VANTAGE ANALYZER DCA VANTAGE CGX SIEMENS HEALTHCARE DIAGNOSTICS INC. 0644122

Patients

Seq Age Sex Outcome Treatment
1