BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    IQ 200 SYSTEM

    MDR report key: 6096739 · Received November 11, 2016

    Report

    Report Number
    2023446-2016-00402
    Event Type
    Malfunction
    Date Received
    November 11, 2016
    Date of Event
    October 28, 2016
    Report Date
    October 28, 2016
    Manufacturer
    IRIS INTERNATIONAL
    Product Code
    KQO
    PMA / PMN Number
    K022774
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    THE FIELD SERVICE ENGINEER (FSE) WAS AT THE CUSTOMER SITE AND OBSERVED THAT THE EVACUATION BYPASS VALVE (EBV) WAS CAUSING THE CONTROL FAILURES. THE FSE REPLACED THE EBV TO ADDRESS THE REPORTED ISSUE. THE REPAIRS WERE VERIFIED AS PER SERVICE PROCEDURES. BEC INTERNAL IDENTIFIER FOR THIS REPORT IS (B)(6).

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT BF CONTROL LEVEL 1 AND LEVEL 2 FAILED FOR RBC (LOW) AFTER REPLACING THE FILTER, LYSE AND DILUENT ON THEIR IQ 200 SYSTEM. THERE WERE NO ERRONEOUS PATIENT RESULTS GENERATED. THERE WAS NO CHANGE TO PATIENT TREATMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    747205 IQ 200 SYSTEM AUTOMATED URINALYSIS SYSTEM KQO IRIS INTERNATIONAL NA

    Patients

    Seq Age Sex Outcome Treatment
    1