FDA Adverse Event Death Summary report: N

TOX/SEE DRUG SCREEN

MDR report key: 3601909 · Received January 17, 2014

Report

Report Number
2915274-2014-00001
Event Type
Death
Date Received
January 17, 2014
Report Date
January 21, 2014
Manufacturer
BIO-RAD LABORATORIES INC
Product Code
DIO
PMA / PMN Number
K031759
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

ON (B)(6) 2014, A CUSTOMER REPORTED DISCREPANT RESULTS USING TOX/SEE KIT 195-5221. THE RESULTS SHOWED POSITIVE FOR BENZODIAZEPINES (BZO), TRICYCLIC ANTIDEPRESSANTS (TCA), OPIATES, METHAMPHETAMINES, AND THC. F/U TESTING SHOWED POSITIVE FOR BZO, TCA, AND THC, BUT NEGATIVE FOR OPIATES AND METHAMPHETAMINES. THE PT REPORTEDLY DIED OF AN OVERDOSE. DUE TO THE LIMITED INFO PROVIDED IT IS UNCLEAR IF THE TOX/SEE DRUG SCREEN MALFUNCTIONED OR LED TO THIS ADVERSE EVENT REPORT. INVESTIGATION IS ONGOING AND ADD'L PRODUCT INFO HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
45549 TOX/SEE DRUG SCREEN TOX/SEE DIO BIO-RAD LABORATORIES INC UNK

Patients

Seq Age Sex Outcome Treatment
1 39 YR Death UNK IF PHYSICIAN UTILIZED ADD'L MEDICAL PRODUCTS| OR THERAPIES PRIOR TO OR AFTER TREATMENT OF EVENT