FDA Adverse Event Malfunction Summary report: N

DIMENSION VISTA 1500

MDR report key: 3940713 · Received July 17, 2014

Report

Report Number
1226181-2014-00381
Event Type
Malfunction
Date Received
July 17, 2014
Date of Event
June 25, 2014
Report Date
June 25, 2014
Manufacturer
SIEMENS HEALTHCARE DIAGNOSTICS INC
Product Code
JJE
PMA / PMN Number
K051087
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

A SIEMENS CUSTOMER SERVICE ENGINEER (CSE) WAS DISPATCHED TO THE CUSTOMER SITE. AFTER EVALUATION OF THE INSTRUMENT AND INSTRUMENT DATA, THE CSE REPLACED THE SAMPLE PROBE 1 MIXER. THE CAUSE OF THE DISCORDANT, FALSELY LOW MAGNESIUM RESULT WAS A SAMPLE PROBE 1 MIXER MALFUNCTION. THE INSTRUMENT IS PERFORMING ACCORDING TO SPECIFICATIONS. NO FURTHER EVALUATION OF THE DEVICE IS REQUIRED.

Description of Event or Problem · 1

A DISCORDANT, FALSELY LOW MAGNESIUM RESULT WAS OBTAINED ON ONE PATIENT SAMPLE ON A DIMENSION VISTA 1500 INSTRUMENT. THE DISCORDANT RESULT WAS REPORTED TO THE PHYSICIAN(S), WHO QUESTIONED IT. THE SAMPLE WAS REPEATED ON AN ALTERNATE INSTRUMENT, RESULTING HIGHER. THE CORRECTED RESULT WAS REPORTED TO THE PHYSICIAN(S). THERE ARE NO REPORTS OF PATIENT INTERVENTION OR ADVERSE HEALTH CONSEQUENCES DUE TO THE DISCORDANT, FALSELY LOW MAGNESIUM RESULT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
418584 DIMENSION VISTA 1500 CLINICAL CHEMISTRY ANALYZER JJE SIEMENS HEALTHCARE DIAGNOSTICS INC DIMENSION VISTA 1500

Patients

Seq Age Sex Outcome Treatment
1