BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    IMMULITE 2000 PROSTATE SPECIFIC ANTIGEN

    MDR report key: 3201837 · Received July 2, 2013

    Report

    Report Number
    2432235-2013-00258
    Event Type
    Malfunction
    Date Received
    July 2, 2013
    Date of Event
    February 19, 2013
    Report Date
    June 13, 2013
    Manufacturer
    SIEMENS HEALTHCARE DIAGNOSTICS
    Product Code
    MTF
    PMA / PMN Number
    P930027
    Removal / Correction Number
    2432235-06/25/13-003-R
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NL
    Reporter Occupation
    HEALTH PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    SIEMENS HAS INVESTIGATED THE INCIDENCE OF POSITIVE BIAS ON IMMULITE 2000 PSA ASSAY, AND A POSITIVE BIAS OF 20-23 PERCENT RELATIVE TO WHO 96/670 HAS BEEN CONFIRMED. AN URGENT FIELD SAFETY NOTICE (UFSN) - (B)(4) IMMULITE/IMMULITE 2000/IMMULITE 2000 XPI PSA POSITIVE BIAS TO WHO 96/670 - WAS SENT TO CUSTOMERS IN (B)(4) 2013. THE UFSN STATES THAT CUSTOMERS ARE TO DISCONTINUE USE OF THE PRODUCT AND DISCARD AFFECTED KITS REMAINING IN THEIR INVENTORY.

    Additional Manufacturer Narrative · 1

    THE INITIAL MDR 2432235-2013-00258 WAS FILED ON JULY 2, 2013. ADDITIONAL INFORMATION (07/22/2013): UPON SUBSEQUENT REVIEW IT WAS DETERMINED THAT THE CUSTOMER ADDRESS WAS LISTED INCORRECTLY. THE CORRECT ADDRESS HAS BEEN ADDED.

    Additional Manufacturer Narrative · 1

    THE INITIAL MDR 2432235-2013-00258 WAS FILED ON JULY 2, 2013 ADDITIONAL INFORMATION (07/03/2013): THE CAUSE OF THE POSITIVE BIAS ON THE IMMULITE 2000 PSA ASSAY IS A CONTROL SYSTEM DEFICIENCY.

    Description of Event or Problem · 1

    THE CUSTOMER HAS OBSERVED A HIGH RESULT FOR THE IMMULITE PROSTATE SPECIFIC ANTIGEN (PSA) ASSAY ON AN IMMULITE 2000 INSTRUMENT USING REAGENT LOT 381. THE PATIENT RESULT WAS REPORTED TO THE PHYSICIAN(S). THE PATIENT SAMPLE WAS ALSO RUN ON AN ALTERNATE PLATFORM WHERE THE RESULTS WERE LOWER. THERE ARE NO KNOWN REPORTS OF PATIENT INTERVENTION OR ADVERSE HEALTH CONSEQUENCES DUE TO THE HIGH BIAS ON THE PSA ASSAY WHEN USING REAGENT LOT 381 AND WHEN COMPARED TO THE ALTERNATE PLATFORM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    301099 IMMULITE 2000 PROSTATE SPECIFIC ANTIGEN IMMULITE 2000 PROSTATE SPECIFIC ANTIGEN MTF SIEMENS HEALTHCARE DIAGNOSTICS IMMULITE 2000 PROSTATE SPECIFIC ANTIGEN 381

    Patients

    Seq Age Sex Outcome Treatment
    1