FDA Adverse Event Malfunction Summary report: N

AIA-360

MDR report key: 6953160 · Received October 16, 2017

Report

Report Number
8031673-2017-00054
Event Type
Malfunction
Date Received
October 16, 2017
Date of Event
September 15, 2017
Report Date
October 25, 2018
Manufacturer
TOSOH CORPORATION
Product Code
KHO
PMA / PMN Number
K971103
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

TOSOH BIOSCIENCE, INC. IS SUBMITTING ON BEHALF OF THE FOREIGN MANUFACTURER, TOSOH CORPORATION, PER EXEMPTION NUMBER E2017013. SUBMISSION OF THIS REPORT DOES NOT CONSTITUTE AN ADMISSION THAT THE IMPORTER OR MANUFACTURER'S PRODUCT CAUSED OR CONTRIBUTED TO THE EVENT.

Additional Manufacturer Narrative · 0

TOSOH BIOSCIENCE, INC. IS SUBMITTING ON BEHALF OF THE FOREIGN MANUFACTURER, TOSOH CORPORATION, PER EXEMPTION NUMBER E2017013. REPORT SOURCE: UNDER THE ABOVE SECTION "USER FACILITY" WAS INCORRECTLY SELECTED. THE ONLY REPORT SOURCE IS "HEALTH PROFESSIONAL".

Additional Manufacturer Narrative · 0

TOSOH BIOSCIENCE, INC. IS SUBMITTING ON BEHALF OF THE FOREIGN MANUFACTURER, TOSOH CORPORATION, PER EXEMPTION NUMBER E2017013. A COMPLAINT HISTORY REVIEW FOR SERIAL (B)(4) WAS PERFORMED FROM 17-AUG-2016 THROUGH 17-SEP-2017 FOR SIMILAR COMPLAINTS. NO OTHER SIMILAR COMPLAINTS WERE IDENTIFIED DURING THE SEARCHED PERIOD. THE AIA-360 OPERATOR'S MANUAL UNDER CHAPTER 2 - 4. INSTALLATION PROCEDURES STATES TO USE THE COLOR CODING FOR THE LEVEL SENSOR LEAD WIRES TO ENSURE THAT THEY ARE CORRECTLY CONNECTED TO THE ELECTRODES FOR EACH BOTTLE. GREEN FOR THE DILUENT BOTTLE AND YELLOW FOR THE WASH SOLUTION BOTTLE. CHAPTER 4-1, PRIOR TO COMMENCING OPERATION, RECOMMENDS MAKING SURE TO PROPERLY MIX THE SUBSTRATE, DILUENT AND WASH SOLUTIONS IN ACCORDANCE WITH INSTRUCTIONS PROVIDED IN THE MANUAL. THE ROOT CAUSE OF THE REPORTED ISSUE COULD NOT BE DETERMINED. THE ISSUE WAS RESOLVED BY REPLACING THE WASH DILUENT AND WASH SOLUTION BOTTLES.

Description of Event or Problem · 0

N/A.

Description of Event or Problem · 0

ON 17-SEP-2017 A CUSTOMER REPORTED BEING UNABLE TO PASS QUALITY CONTROLS (QC); THEREFORE, COULD NOT RUN PATIENT SAMPLES FOR TROPONIN ON THE AIA-360 ANALYZER. THE CUSTOMER REPORTED THAT THE ISSUE BEGAN ON (B)(6) 2017 EVEN AFTER REPLACING THE WASH DILUENT AND WASH SOLUTION BOTTLES ON THE AIA-360. THE CUSTOMER STATED THAT A SECOND AIA-360 WAS EXPERIENCING A SIMILAR ISSUE AS WELL. THE TECHNICAL SUPPORT SPECIALIST SUGGESTED TO THE CUSTOMER TO INSTALL NEW WASH DILUENT AND WASH SOLUTION BOTTLES, PRIME, AND THEN RE-CALIBRATE THE AIA-360 ANALYZER. THE CUSTOMER REPORTED THAT ISSUE AFTER INSTALLING NEW WASH DILUENT AND WASH SOLUTION BOTTLES. THE CUSTOMER WAS UNABLE TO DETERMINE WHICH ONE WAS CAUSING THE REPORTED ISSUES SINCE BOTH WERE MADE AND PRIMED INTO THE SYSTEM AT THE SAME TIME. THERE IS NO INDICATION OF ANY PATIENT INTERVENTION OR ADVERSE HEALTH CONSEQUENCES DUE TO THE DELAY IN REPORTING OF PATIENT RESULTS FOR TROPONIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
731464 AIA-360 AIA-360 KHO TOSOH CORPORATION AIA-360

Patients

Seq Age Sex Outcome Treatment
1