DIMENSION VISTA CLINICAL CHEMISTRY SYSTEM
Report
- Report Number
- 1226181-2015-00288
- Event Type
- Malfunction
- Date Received
- May 22, 2015
- Date of Event
- October 31, 2014
- Report Date
- May 11, 2015
- Manufacturer
- SIEMENS HEALTHCARE DIAGNOSTICS INC.
- Product Code
- JJE
- PMA / PMN Number
- K051087
- Removal / Correction Number
- 1226181-05/21/2015-002-C
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- HEALTH PROFESSIONAL
Narratives
SIEMENS HEALTHCARE DIAGNOSTICS HAS IDENTIFIED THE FOLLOWING TWO ISSUES USING DIMENSION VISTA INTELLIGENT LAB SYSTEM SOFTWARE VERSIONS 3.6.1, 3.6.1_MU3P, AND 3.6.1SP1. THE FIRST ISSUE IS THAT SAMPLES MAY STOP PROCESSING WITHOUT NOTIFICATION. THE SECOND ISSUE, WHICH CAN ONLY OCCUR ON THE DIMENSION VISTA 1500 SYSTEM, IS UNEXPECTED RESULTS DUE TO A TIMING ISSUE THAT CAUSES A REAGENT SERVER TO TEMPORARILY LOSE SYNCHRONIZATION DURING THE AUTOMATIC REMOVAL OF REAGENT CARTRIDGES FROM REAGENT SERVER 2 TO WASTE A CONTAINER. IN THIS SCENARIO, INCORRECT REAGENT OR NO REAGENT DELIVERY MAY OCCUR. AN URGENT MEDICAL DEVICE CORRECTION (UMDC) WAS SENT TO CUSTOMERS WITHIN THE US IN MAY 2015 AND AN URGENT FIELD SAFETY NOTICE (UFSN) WAS SENT TO CUSTOMERS OUTSIDE THE UNITED STATES IN MAY 2015. THE UMDC AND UFSN ARE FOR THE DIMENSION VISTA 500 INTELLIGENT LAB SYSTEM AND THE DIMENSION VISTA 1500 INTELLIGENT LAB SYSTEM AND ARE ENTITLED "INFORMATION REGARDING VISTA SOFTWARE ISSUES." THE UMDC/UFSN EXPLAIN THESE ISSUES AND PROVIDE ACTIONS CUSTOMERS CAN TAKE IF THEY EXPERIENCE THEM. SIEMENS WILL BE PROVIDING CORRECTIONS FOR THESE ISSUES IN A FUTURE VISTA SOFTWARE VERSION.
THE OPERATOR OF A DIMENSION VISTA INSTRUMENT DISCOVERED THAT THREE SAMPLE RACKS LOADED ON THE INSTRUMENT WERE NOT PROCESSING AND THE INSTRUMENT INDICATED "NOT STARTED." THE OPERATOR PAUSED THE SYSTEM, THEN CANCELLED THE PAUSE, WHICH RESOLVED THE ISSUE. THERE ARE NO KNOWN REPORTS OF PATIENT INTERVENTION OR ADVERSE HEALTH CONSEQUENCES DUE TO THIS ISSUE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 334089 | DIMENSION VISTA CLINICAL CHEMISTRY SYSTEM | CLINICAL CHEMISTRY ANALYZER | JJE | SIEMENS HEALTHCARE DIAGNOSTICS INC. | DIMENSION VISTA 500 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |