FDA Adverse Event Malfunction Summary report: N

DIMENSION VISTA® UREA NITROGEN FLEX® REAGENT CARTRIDGE

MDR report key: 5499687 · Received March 14, 2016

Report

Report Number
2517506-2016-00128
Event Type
Malfunction
Date Received
March 14, 2016
Date of Event
December 30, 2015
Report Date
February 16, 2016
Manufacturer
SIEMENS HEALTHCARE DIAGNOSTICS INC - GLASGOW
Product Code
CDQ
PMA / PMN Number
K051087
Removal / Correction Number
2517506-02-26-2016-002-C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CT, US
Reporter Occupation
MEDICAL TECHNOLOGIST

Narratives

Additional Manufacturer Narrative · 1

SIEMENS HEALTHCARE DIAGNOSTICS HAS DETERMINED THAT DIMENSION VISTA® BLOOD UREA NITROGEN (BUN) LOTS 15215AE, 15243BB, 15264BA, 15299BB, 15300BA, 15320BB, AND 15341AC MAY EXHIBIT INACCURATE PATIENT AND/OR QUALITY CONTROL RESULTS. ONLY SPECIFIC REAGENT CARTRIDGE WELLS ARE AFFECTED. IF CALIBRATION IS PERFORMED USING AN UNAFFECTED WELL AND PATIENT RESULTS ARE SUBSEQUENTLY RUN USING AN AFFECTED WELL, BUN RESULTS MAY BE FALSELY DEPRESSED BY UP TO APPROXIMATELY 50%. IF CALIBRATION IS PERFORMED USING AN AFFECTED WELL, BUN RESULTS MAY BE FALSELY ELEVATED BY UP TO APPROXIMATELY 64%. SIEMENS ISSUED AN URGENT MEDICAL DEVICE CORRECTION DATED FEBRUARY 2016, COMMUNICATION VC-16.01.B.US TO ALL U.S ACCOUNTS OR AN URGENT FIELD SAFETY NOTICE VC-16-01.B.OUS, TO ALL OUTSIDE U.S. ACCOUNTS WHO HAD BEEN SHIPPED THE IMPACTED LOTS. CUSTOMERS WERE DIRECTED TO DISCARD CERTAIN FLEXES WITH A SPECIFIC LOT NUMBER/CAVITY NUMBER COMBINATION. SIEMENS OFFERED A NO CHARGE REPLACEMENT OR CREDIT FOR DISCARDED INVENTORY.

Description of Event or Problem · 1

THE CUSTOMER NOTED DISCREPANT LOW BUN QC RESULTS WITHIN A DIMENSION VISTA FLEX(R) REAGENT CARTRIDGE WELL SET. THE SAMPLES WERE REPEATED ON AN ALTERNATE FLEX CARTRIDGE AND HIGHER RESULTS WERE OBTAINED WITHIN LABORATORY RANGES. THERE IS NO INDICATION THAT ERRONEOUS PATIENT RESULTS WERE REPORTED. THERE IS NO INDICATION THAT PATIENT TREATMENT WAS ALTERED OR PRESCRIBED ON THE BASIS OF DISCREPANT BUN RESULTS. THERE WAS NO REPORT OF ADVERSE HEALTH CONSEQUENCES AS A RESULT OF THE DISCREPANT BUN RESULTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
155110 DIMENSION VISTA® UREA NITROGEN FLEX® REAGENT CARTRIDGE DIMENSION VISTA® UREA NITROGEN FLEX® REAGENT CARTRIDGE CDQ SIEMENS HEALTHCARE DIAGNOSTICS INC - GLASGOW 10445159 15320BB

Patients

Seq Age Sex Outcome Treatment
1