FDA Adverse Event Malfunction Summary report: N

ICHEM 100

MDR report key: 3748664 · Received November 22, 2013

Report

Report Number
2023446-2013-00001
Event Type
Malfunction
Date Received
November 22, 2013
Date of Event
August 7, 2013
Report Date
November 22, 2013
Manufacturer
IRIS INTERNATIONAL
Product Code
JJW
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

IRIS PRODUCT IFU INSERT STATES THAT THE DIAGNOSTIC OR THERAPEUTIC DECISIONS SHOULD NOT BE BASED ON ANY SINGLE RESULT OR METHOD. THEREFORE, DECISION OF CLINICIAN TO ADMINISTER THERAPY BASED ON SINGLE FALSE POSITIVE OR FALSE NEGATIVE RESULT IS INDICATIVE OF USES OF DEVICE OFF LABELED CLAIM. THE FOLLOWING MDR IS RELATED TO THIS EVENT, WHICH DOCUMENTS THE OTHER REAGENT LOT# GENERATED ON DIFFERENT DATE: 2023446-2013-00002.

Description of Event or Problem · 1

CUSTOMER REPORTED FALSE POSITIVE LEUKOCYTE ESTERASE RESULTED IN PTS RECEIVING UNNECESSARY ANTIBIOTIC PRESCRIBED BY PHYSICIANS. THE FALSE POSITIVE WAS CONFIRMED VIA URINE MICROSCOPY AND URINE CULTURES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
610226 ICHEM 100 URINE CHEMISTRY STRIPS JJW IRIS INTERNATIONAL 800-7005 510033A

Patients

Seq Age Sex Outcome Treatment
1 Other