UNICEL DXI® 800 ACCESS® IMMUNOASSAY SYSTEM
Report
- Report Number
- 2122870-2013-00575
- Event Type
- Malfunction
- Date Received
- June 27, 2013
- Date of Event
- May 29, 2013
- Report Date
- May 30, 2013
- Manufacturer
- BECKMAN COULTER
- Product Code
- DHA
- PMA / PMN Number
- K023764
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- PA, US
- Reporter Occupation
- HEALTH PROFESSIONAL
Narratives
A BECKMAN COULTER FSE (FIELD SERVICE ENGINEER) WAS DISPATCHED ON (B)(4) 2013 AND PROACTIVELY REPLACED THE ASPIRATE PROBE TUBING WITHOUT COMPLETING ANY OTHER REPAIRS. THE FSE DID NOT PROVIDE EVIDENCE TO REASONABLY CONCLUDE THE ASPIRATE PROBE TUBING HAD MALFUNCTIONED. A SIMILAR EVENT RECURRED ON (B)(6) 2013 AND AN FSE WAS DISPATCHED AGAIN. PLEASE SEE MEDWATCH REPORT # 2122870-2013-00576 FOR AN ASSOCIATED REPORT OF THE EVENT WHICH OCCURRED ON (B)(6) 2013. THE FSE REPORTED THAT THE SAMPLE PIPETTOR FAILED CARRYOVER TESTING AND THE FSE PROCEEDED TO REPLACE THE PIPETTE TIP. THE FSE VERIFIED REPAIR PER ESTABLISHED PROCEDURES AND OBTAINED PASSING CARRYOVER TESTING AND BHCG PRECISION TESTS WITH QC MATERIAL. RESULTS: FAILURE MODE IS ATTRIBUTED TO THE SAMPLE PIPETTE TIP AND REPLACEMENT OF THE TIP RESOLVED THE ISSUE. ALL RELATED MEDWATCH REPORTS ASSOCIATED WITH THIS EVENT: 2122870-2013-00575 2122870-2013-00576.
THE CUSTOMER REPORTED OBTAINING NON-REPRODUCIBLE, ELEVATED ACCESS HCG (BETA-HUMAN CHORIONIC GONADOTROPIN) PATIENT RESULTS, FOR TWO (2) PATIENTS, INVOLVING THE UNICEL DXI 800 ACCESS IMMUNOASSAY SYSTEM. THE CUSTOMER INDICATED THAT REPEAT TESTING OF THE FIRST PATIENT SAMPLE PRODUCED LOWER RESULTS WITHIN THE NORMAL RANGE OF THE ASSAY, ON BOTH THE ORIGINAL INSTRUMENT AND ON THE ALTENATE DXI 800 ANALYZER. REPEAT TESTING OF THE SECOND SAMPLE PRODUCED A HIGHER RESULT ON THE ORIGINAL INSTRUMENT BUT A LOWER RESULT ON THE ALTERNATE DXI 800 ANALYZER. THE PATIENT RESULTS WERE NOT REPORTED OUT OF THE LABORATORY AND THERE WAS NO CHANGE OR AFFECT TO PATIENT TREATMENT IN CONNECTION WITH THIS EVENT. THE CUSTOMER INDICATED THAT SYSTEM CHECKS WERE PASSING PRIOR TO THE EVENT AND QC (QUALITY CONTROL) WAS RECOVERING WITHIN THE CUSTOMER'S ESTABLISHED RANGES.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 294804 | UNICEL DXI® 800 ACCESS® IMMUNOASSAY SYSTEM | ANALYZER, CHEMISTRY (PHOTOMETRIC, DISCRETE), FOR CLINICAL USE | DHA | BECKMAN COULTER | NA | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |