FDA Adverse Event Malfunction Summary report: N

0.8% RESOLVE PANEL B FOR GEL

MDR report key: 3090689 · Received May 2, 2013

Report

Report Number
2250051-2013-00124
Event Type
Malfunction
Date Received
May 2, 2013
Date of Event
April 15, 2013
Report Date
May 2, 2013
Manufacturer
ORTHO CLINICAL DIAGNOSTICS
Product Code
KSZ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

OCD PERFORMED RETAINED TESTING, BATCH RECORD REVIEW, AND COMPLAINT BY LOT REVIEW. ALL RESULTS WERE SATISFACTORY. SAMPLE WAS NOT AVAILABLE TO BE SENT TO OCD FOR FURTHER INVESTIGATION. (B)(4).

Description of Event or Problem · 1

CUSTOMER REPORTED NO REACTIVITY WITH A PATIENT SAMPLE CONFIRMED TO HAVE ANTI-E AND ANTI-S DETECTED IN THE SOLID PHASE METHODOLOGY ON THE ECHO INSTRUMENT. CUSTOMER REPORTED THAT THE PATIENT WAS INITIALLY TESTED ON THE IMMUCOR ECHO AND YIELDED A POSITIVE ANTIBODY SCREEN. CUSTOMER STATED THAT IT IS THEIR PROTOCOL TO REPEAT ANY POSITIVE ANTIBODY SCREEN BY THE ECHO IN THE MANUAL GEL METHOD. PATIENT SAMPLE WAS THEN TESTED BY THE MANUAL GEL METHOD WITH A 15MIN INCUBATION AND NEGATIVE RESULTS WERE OBSERVED. PATIENT SAMPLE WAS THEN TESTED ON THE ECHO FOR ANTIBODY IDENTIFICATION. CUSTOMER QUESTIONED THE NEGATIVE ANTIBODY SCREEN IN GEL AND THEN TESTED THE SAMPLE AGAINST VRA180 WITH A 30MIN INCUBATION. NO REACTIVITY WAS OBSERVED. CUSTOMER PERFORMED ADDITIONAL TESTING OF THE SAMPLE WITH VRB178. NO REACTIVITY WAS OBSERVED. ALL LISTED OCD PRODUCTS HAVE BEEN CONFIRMED TO HAVE NORMAL APPEARANCE AND STORED ACCORDING TO THE RESPECTED IFU. CTS SUGGESTED ANTIGEN TYPING OF THE 0.8% DONORS THAT WERE EXPECTED TO BE POSITIVE FOR THE RESPECTIVE ANTIBODY. CUSTOMER IS UNWILLING TO PERFORM THE SUGGESTED TESTING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
191997 0.8% RESOLVE PANEL B FOR GEL REAGENT RED BLOOD CELLS KSZ ORTHO CLINICAL DIAGNOSTICS VRB178

Patients

Seq Age Sex Outcome Treatment
1