BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    IMPAX CV OUTBOUNG (RESULTS MANAGEMENT 2.08)

    MDR report key: 4605494 · Received December 12, 2014

    Report

    Report Number
    1225058-2014-15735
    Event Type
    Malfunction
    Date Received
    December 12, 2014
    Date of Event
    November 13, 2014
    Report Date
    December 12, 2014
    Manufacturer
    AGFA HEALTHCARE CORPORATION
    Product Code
    LLZ
    PMA / PMN Number
    K050228
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SD, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    AN AGFA CLINICAL ANALYST PERFORMED A RETRO-ANALYSIS AND REPORTED THE FINDINGS TO AGFA SERVICE AND AGFA PRODUCT QUALITY MANAGER. AGFA'S INVESTIGATION INTO THIS OCCURRENCE OF RMAT CUSTOMIZATIONS HAS REVEALED THAT THIS SPECIFIC CHANGE HAD THE POTENTIAL TO INTRODUCE CLINICAL INACCURACIES IN PATIENT REPORTS. SPECIFICALLY: THE ORIGINAL SENTENCE OF "THERE IS RUPTURED CHORDAE OF THE TRICUSPID VALVE" HAS BEEN CHANGED TO "THERE IS MILD PROLAPSE OF THE SEPTAL LEAFLET OF THE TRICUSPID VALVE." IN THIS ISSUE, THE ORIGINAL SENTENCE DESCRIBES A RUPTURED CHORDAE. THE CHANGED SENTENCE HAS A DIFFERENT CLINICAL MEANING INDICATING THE PRESENCE OF MILD SEPTAL LEAFLET PROLAPSE NOT A RUPTURED CHORDAE. POTENTIAL IMPACT: IF THE CHANGE WAS MADE AFTER REPORTS HAD BEEN GENERATED WITH THE ORIGINAL SENTENCE SELECTED, THOSE REPORTS PRIOR TO THE CHANGE COULD DISPLAY INCORRECT CLINICAL DATA IF VIEWED IN RM OR IF USED AS A TEMPLATE FOR A REPEAT STUDY ON THAT PATIENT. THERE HAS BEEN NO REPORTED PATIENT HARM FOR THIS OCCURRENCE. A REPORTABLE CORRECTION IS UNDERWAY FOR THIS ISSUE AND HAS BEEN REPORTED TO THE FDA VIA REFERENCE #Z-2112-10. AGFA WILL FOLLOW THE RMAT POST MARKET VERIFICATION WORK INSTRUCTIONS TO CORRECT THE SENTENCE FINDING. ANY FURTHER INVESTIGATION FOR THE SITE DESCRIBED IN THIS REPORT WILL BE DOCUMENTED IN THE ONGOING CFR PART 806 REPORTING. (B)(6).

    Description of Event or Problem · 1

    AGFA SUBMITTED MDR REPORT #1225058-2010-00001 TO THE FDA ON JUNE 7, 2010, FOR A SITE IN THE US. A 14TH OCCURRENCE IS BEING REPORTED FOR THE SAME ISSUE/SAME DEVICE: IMPAX CV RESULTS MANAGEMENT ADMINISTRATION TOOL (RMAT). THIS IS AN INTERNAL DISCOVERY DETERMINED DURING THE IMPLEMENTATION OF THE ASSOCIATED PROBLEM CORRECTION PLAN, RMAT VERIFICATION, AS REPORTED IN FDA Z-2112-10. WITHIN THIS OCCURRENCE ARE 10 DIFFERENT STUDY DATES IN WHICH AN INDIVIDUAL MDR REPORT WIL BE SUBMITTED FOR EACH ASSOCIATED STUDY DATE AND MEDICAL RECORD NUMBER/S (MRN) IDENTIFIED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    812740 IMPAX CV OUTBOUNG (RESULTS MANAGEMENT 2.08) PICTURE ARCHIVING AND COMMUNICATION LLZ AGFA HEALTHCARE CORPORATION IMPAX CV 2.08 NA

    Patients

    Seq Age Sex Outcome Treatment
    1