FDA Adverse Event Other Summary report: N

ICON 25 HCG

MDR report key: 524440 · Received February 13, 2004

Report

Report Number
2916283-2004-00004
Event Type
Other
Date Received
February 13, 2004
Date of Event
January 14, 2004
Report Date
February 13, 2004
Manufacturer
BECKMAN COULTER, INC.
Product Code
JHJ
Removal / Correction Number
NOT APPLICABLE
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE CUSTOMER INDICATED THAT AN EMERGENCY ROOM (ER) PT HAD A URINE SAMPLE TESTED WITH AN ICON 25 HCG TEST KIT AND THE HCG RESULT WAS NEGATIVE (-). A SERUM SAMPLE WAS ALSO COLLECTED FROM THE PT AND WAS TESTED QUANTITATIVELY FOR BHCG. THE QUANTITATIVE BHCG RESULT WAS >200,000 MIU/ML. THE URINE SAMPLE WAS RETESTED USING A DIFFERENT TYPE OF HCG TEST KIT AND THE RESULT WAS POSITIVE (+). THERE HAS BEEN NO CHANGE TO PT TREATMENT THAT CAN BE ATTRIBUTED TO THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ICON 25 HCG QUALITATIVE HCG TEST JHJ BECKMAN COULTER, INC. NA HCG030605

Patients

Seq Age Sex Outcome Treatment
1 NA Other