FDA Adverse Event Malfunction Summary report: N

STACLOT PROTEIN S

MDR report key: 31216 · Received December 12, 1995

Report

Report Number
43429-1995-00001
Event Type
Malfunction
Date Received
December 12, 1995
Report Date
December 7, 1995
Manufacturer
DIAGNOSTICA STAGO
Product Code
JGR
Product Problem
Yes
Report Source
Distributor report
Reporter Location
US
Reporter Occupation
UNKNOWN

Narratives

Description of Event or Problem · 1

A MEDICAL TECHNOLOGIST IN THE COAGULATION LABORATORY WAS COMPARING LOT 953124 WITH ANOTHER PREVIOUSLY USED LOT 953076 OF THE SAME KIT BY RUNNING BOTH LOTS IN PARELLEL TO TEST A PLASMA THAT HAD BEEN CONFIRMED TO BE DEFICIENT IN PROTEIN S ACTIVITY. THE TEST PLASMA HAD AN EXPECTED LEVEL OF 38% ACTIVITY; HOWEVER LOT 953124 OBTAINED 54%, WHEREAS THE LOT 953076 YIELDED 43%, THE LATTER BEING MUCH CLOSER TO THE TARGET VALUE (38%). THIS OVERESTIMATION BY LOT 953124 WAS NOT NEGLIBIBLE, AND WAS CONSIDERED TO BE DUE TO THE TEST PLASMA BEING FROM A HETEROZYGOUS PT. IN THE UNITED STATES THE DISTRIBUTOR HAS NOT RECEIVED ANY REPORT OF THIS NATURE ABOUT LOT 953124 AS OF THIS DATE.INVALID DATA - REGARDING SINGLE USE LABELING OF DEVICE. PATIENT MEDICAL STATUS PRIOR TO EVENT: UNKNOWN. INVALID DATA - REGARDING MULTIPLE PATIENT INVOLVEMENT.INVALID DATA - ON DEVICE SERVICE/MAINTENANCE. NO DATA - REGARDING DATE LAST SERVICED. SERVICE PROVIDED BY: INVALID DATA. INVALID DATA - SERVICE RECORDS AVAILABILITY.INVALID DATA - REGARDING WHETHER EVENT PRESENTS IMMINENT HAZARD. DEVICE USED AS LABELED/INTENDED.DEVICE WAS EVALUATED AFTER THE EVENT. METHOD OF EVALUATION: A DEVICE FROM SAME LOT WAS EVALUATED. RESULTS OF EVALUATION: UNANTICIPATED. CONCLUSION: DEVICE WAS OUT OF SPEC IN A MANNER THAT RELATES TO EVENT. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: YES. CORRECTIVE ACTIONS: DEVICE RECALLED BY MANUFACTURER/DISTRIBUTOR. THE DEVICE WAS DESTROYED/DISPOSED OF.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 STACLOT PROTEIN S IN VITRO DIAGNOSTIC TEST KIT/PROTEIN S ACTIVITY IN PLASMA JGR DIAGNOSTICA STAGO

Patients

Seq Age Sex Outcome Treatment
1 UNK Other