BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CDS/R/4K DILUENT/SHEATH, 20L

    MDR report key: 807049 · Received January 8, 2007

    Report

    Report Number
    2919069-2007-00011
    Event Type
    Malfunction
    Date Received
    January 8, 2007
    Date of Event
    October 7, 2006
    Report Date
    December 15, 2006
    Manufacturer
    ABBOTT DIAGNOSTICS DIV/CELLDYN
    Product Code
    GKL
    PMA / PMN Number
    k961439
    Removal / Correction Number
    2919069-1/4/07-001-C
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    MEDICAL TECHNOLOGIST

    Narratives

    Additional Manufacturer Narrative · 1

    USE OF DILUENT SHEATH LOT 42063I2 CAN CAUSE ERRORS IN RESULTS WHEN USED ON THE CELL-DYN RUBY. CELL-DYN SAPPHIRE AND CELL-DYN 4000. RESULTS THAT MAY BE IMPACTED INCLUDE RBC, MCV, RDW, PLATELETS AND MPV. THE IMPACT TO RESULTS VARIES BY INSTRUMENT TYPE AS WELL AS THE MATERIAL TESTED, I.E., CONTROL, CONTROL TYPE OR WHOLE BLOOD. RESULTS THAT MAY BE IMPACTED INCLUDE SMALL (LESS THAN 5%) SHIFTS IN RBC, MCV, RDW, AND MPV ALONG WITH 10-20% SHIFT IN OPTICAL PLATELET COUNTS. THIS IS AN INITIAL REPORT. AN INVESTIGATION IS IN PROCESS. A FINAL REPORT WILL BE SUBMITTED WHEN THE INVESTIGATION IS COMPLETE.

    Description of Event or Problem · 1

    THE ACCOUNT STATED THAT MCV, MCHC AND PLATELET OPTICAL IS OUT OF RANGE ON MULTIPLE LEVELS OF QC WHEN TESTED ON THE CELL-DYN 4000 ANALYZER. THERE WAS NO REPORT OF INCORRECT PT RESULTS OR IMPACT TO PT MANAGEMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CDS/R/4K DILUENT/SHEATH, 20L DILUENT/SHEATH FOR USE ON THE CELL-DYN SAPPHIRE, CELL-DYN 40 GKL ABBOTT DIAGNOSTICS DIV/CELLDYN NA 42063I2

    Patients

    Seq Age Sex Outcome Treatment
    1 NA CELL-DYN 4000 ANALYZER LIST #1H01-01