FDA Adverse Event Other Summary report: N

SYSMEX CA-1500

MDR report key: 509828 · Received January 20, 2004

Report

Report Number
1422681-2003-00004
Event Type
Other
Date Received
January 20, 2004
Date of Event
December 4, 2003
Report Date
January 13, 2004
Manufacturer
SYSMEX CORPORATION
Product Code
JPA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

THE SYSMEX CA-1500 AUTOMATED COAGULATION ANALYZER CORRECTLY REPORTED AN ERROR MESSAGE (CODE 128) ON A PT SAMPLE DURING APTT TESTING WITH ACTIN FSL. CONTRARY TO INSTRUCTIONS PROVIDED BY THE MANUFACTURER (SYSMEX CORPORATION) THE LABORATORY TECHNICIAN IGNORED THE RESULT FLAG AND MANUALLY CALCULATED THE RESULT. THIS LED TO THE REPORTING OF AN INCORRECT RESULT, THE PT WAS OVER-HEPARINIZED AND SUBSEQUENTLY BLED. PT RECEIVED MEDICAL INTERVENTION IN THE FORM OF THREE UNITS OF RBCS TO STABILIZE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYSMEX CA-1500 AUTOMATED COAGULATION ANALYZER JPA SYSMEX CORPORATION CA-1500 NA

Patients

Seq Age Sex Outcome Treatment
1 56 YR Required Intervention