FDA Adverse Event Malfunction Summary report: N

1823260-2017-00779

MDR report key: 6493783 · Received April 14, 2017

Report

Report Number
1823260-2017-00779
Event Type
Malfunction
Date Received
April 14, 2017
Date of Event
March 15, 2017
Report Date
May 22, 2017
PMA / PMN Number
K100853
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

A SPECIFIC ROOT CAUSE COULD NOT BE DETERMINED. THE MOST LIKELY ROOT CAUSE WAS A PREANALYTICAL ISSUE SUCH AS A CENTRIFUGE WITH A TOO HIGH SPEED OR A TOO SHORT CLOTTING TIME. THESE ISSUES WOULD RESULT IN CLOT FORMATION IN THE SAMPLE AND AFFECT THE SAMPLE QUALITY. OTHER POSSIBLE CAUSES INCLUDE INSUFFICIENT MAINTENANCE OR CONTAMINATION OF THE ENVIRONMENT WITH THE ANALYTE. THE DIFFERENCES BETWEEN THE RESULTS FROM THE DIFFERENT DRAW DATES ARE VERY LIKELY DUE TO AN UNKNOWN CLINICAL STATUS OF THE PATIENT OR DUE TO MEDICATION. A GENERAL REAGENT ISSUE WAS NOT SUSPECTED BASED ON THE PROVIDED QC DATA.

Additional Manufacturer Narrative · 1

UNIQUE IDENTIFIER (UDI)#: (B)(4). THIS EVENT OCCURRED IN (B)(6).

Description of Event or Problem · 1

THE CUSTOMER RECEIVED A QUESTIONABLE ELECSYS FERRITIN RESULT FOR ONE PATIENT SAMPLE. THE INITIAL RESULT WAS 88.80 UG/L AND WAS REPORTED OUTSIDE THE LABORATORY. THE CLINICIAN DID NOT AGREE WITH THIS RESULT COMPARED TO THE OTHER BIOLOGICAL AND CLINICAL TESTS PERFORMED. THE PATIENT WAS REDRAWN ON (B)(6) 2017 AND THE RESULT FOR THIS SAMPLE WAS 18.84 UG/L. THE RESULT FROM ANOTHER COBAS 8000 E 602 MODULE WAS 19.05 UG/L. THESE RESULTS MATCHED THE OTHER TESTS PERFORMED. THE SAMPLE FROM (B)(6) 2017 WAS THEN REPEATED AND THE RESULTS WERE 46.18 UG/L AND 37.29 UG/L. THE RESULTS FROM THE OTHER COBAS 8000 E 602 MODULE WERE 35.16 UG/L AND 35.82 UG/L. THERE WAS NO ALLEGATION OF AN ADVERSE EVENT. THE REAGENT LOT NUMBER WAS 192154. THE EXPIRATION DATE WAS REQUESTED BUT WAS NOT PROVIDED. THE LABORATORY CONFIRMED THERE WAS NO MIX UP OF THE SAMPLE IDENTIFICATION AS ALL OTHER PARAMETERS GAVE THE SAME RESULTS.

Patients

Seq Age Sex Outcome Treatment
1 56 YR