BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CARCINOEMBRYONIC ANTIGEN - CEA

    MDR report key: 5315568 · Received December 21, 2015

    Report

    Report Number
    1823260-2015-06082
    Event Type
    Malfunction
    Date Received
    December 21, 2015
    Date of Event
    November 27, 2015
    Report Date
    January 7, 2016
    Manufacturer
    ROCHE DIAGOSTICS
    Product Code
    DHX
    PMA / PMN Number
    K980887
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    HEALTH PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    THE PATIENT SAMPLE TESTED FOR CEA FROM (B)(6) 2015 WAS SUBMITTED FOR INVESTIGATION. THE SAMPLE WAS MEASURED AND A VALUE OF >100,000 NG/ML WAS OBTAINED AFTER DILUTION. THE INITIAL RESULT OF 632.9 NG/ML AT THE INVESTIGATION SITE WAS DUE TO A HIGH DOSE HOOK EFFECT. THE INCREASED VALUES FOR CEA WERE VERIFIED IN THE DILUTED SAMPLE. THE CUSTOMER'S CEA RESULTS WERE REPRODUCIBLE. THE CEA ASSAY MEETS PRODUCT SPECIFICATION.

    Additional Manufacturer Narrative · 1

    THIS EVENT OCCURRED IN (B)(6).

    Additional Manufacturer Narrative · 1

    THE CUSTOMER PROVIDED AN ADDITIONAL PATIENT SAMPLE DRAWN ON (B)(6) 2015 FOR INVESTIGATION THAT WAS TESTED FOR CEA. SEE THE ATTACHMENT TO THE MEDWATCH FOR THE PATIENT RESULTS AND OTHER RELEVANT CEA RESULTS.(B)(4). THE CEA REAGENT LOT NUMBER USED AT THE INVESTIGATION SITE WAS 185168. THE EXPIRATION DATE WAS NOT PROVIDED.

    Description of Event or Problem · 1

    THE PHYSICIAN IS QUESTIONING THE RESULTS FROM 1 PATIENT SAMPLE TESTED FOR CARBOHYDRATE ANTIGEN 19-9 (CA 19-9) AND CARCINOEMBRYONIC ANTIGEN (CEA). THE PHYSICIAN INDICATES THE CA 19-9 AND CEA RESULTS ARE ELEVATED COMPARED TO THE CLINICAL STATUS OF THE PATIENT. BASED ON THE DATA PROVIDED, ERRONEOUS RESULTS WERE GENERATED FOR BOTH CA 19-9 AND CEA. COMPARISON TESTING WAS PERFORMED BETWEEN THE CUSTOMER'S E601 ANALYZER, AN E MODULE ANALYZER AT ANOTHER HOSPITAL AND A LUMIPULSE METHOD. THE ERRONEOUS RESULTS WERE REPORTED OUTSIDE OF THE LABORATORY. THE CUSTOMER SUBMITTED THE PATIENT SAMPLE FOR INVESTIGATION. BASED ON THE DATA PROVIDED ERRONEOUS CA 19-9 RESULTS WERE IDENTIFIED BETWEEN THE E411 ANALYZER USED AT THE INVESTIGATION SITE AND BOTH THE LUMIPULSE RESULTS THAT THE CUSTOMER ORGANIZED AND THE ARCHITECT RESULTS THAT THE INVESTIGATION UNIT ORGANIZED. ERRONEOUS CEA RESULTS WERE IDENTIFIED BETWEEN THE E411 ANALYZER USED AT THE INVESTIGATION SITE AND THE LUMIPULSE RESULTS ORGANIZED BY THE CUSTOMER. THIS MEDWATCH WILL COVER CEA. REFER TO MEDWATCH WITH PATIENT IDENTIFIER (B)(6) FOR INFORMATION ON THE CA 19-9 ERRONEOUS RESULTS. NO ADVERSE EVENT WAS REPORTED. THE CUSTOMER'S E601 ANALYZER SERIAL NUMBER WAS NOT PROVIDED. THE E411 SERIAL NUMBER USED AT THE INVESTIGATION SITE WAS (B)(4). THE CEA REAGENT LOT NUMBER USED AT THE INVESTIGATION SITE WAS 180801. THE EXPIRATION DATE WAS NOT PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    840468 CARCINOEMBRYONIC ANTIGEN - CEA SYSTEM, TEST, CARCINOEMBRYONIC ANTIGEN DHX ROCHE DIAGOSTICS NA ASKU

    Patients

    Seq Age Sex Outcome Treatment
    1