FDA Adverse Event Malfunction Summary report: N

I-STAT B-HCG CARTRIDGE

MDR report key: 8268168 · Received January 22, 2019

Report

Report Number
2245578-2019-00013
Event Type
Malfunction
Date Received
January 22, 2019
Date of Event
January 12, 2019
Report Date
February 13, 2019
Manufacturer
ABBOTT POINT OF CARE
Product Code
DHA
UDI-DI
10054749001009
PMA / PMN Number
K133002
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KS, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

APOC INCIDENT #: (B)(4). THE INVESTIGATION WAS COMPLETED ON 02/05/2019. A REVIEW OF THE DEVICE HISTORY RECORD (DHR) CONFIRMED THAT THE CARTRIDGE LOT MET FINISHED GOODS (FG) RELEASE CRITERIA. RETAINED AND RETURNED CARTRIDGE TESTING MET THE ACCEPTANCE CRITERIA OUTLINED IN APPENDIX 1 OF Q04.01.003 REV. AC (PRODUCT COMPLAINT LEVEL 2 AND LEVEL 3 INVESTIGATION PROCEDURE).NO DEFICIENCY HAS BEEN IDENTIFIED FOR SS-HCG CARTRIDGE LOT F18331.

Description of Event or Problem · 0

NA.

Additional Manufacturer Narrative · 1

(B)(4). APOC LABELING WILL BE EVALUATED DURING THE INVESTIGATION AS PERTAINING TO THE EVENT.

Description of Event or Problem · 1

ON (B)(6) 2019, ABBOTT POINT OF CARE (APOC) WAS CONTACTED BY A CUSTOMER REGARDING I-STAT B-HCG CARTRIDGES THAT YIELDED SUSPECTED FALSE POSITIVE RESULTS ON A (B)(6) FEMALE PATIENT WITH A VAGINAL BLEED. THERE WAS NO ADDITIONAL PATIENT INFORMATION. RETURN PRODUCT IS AVAILABLE FOR INVESTIGATION. (B)(6). THERE ARE NO INJURIES ASSOCIATED WITH THIS EVENT. AT THIS TIME THERE IS NO REASON TO SUSPECT A MALFUNCTION EXISTS. IT IS SUSPECTED THAT THE POSITIVE RESULTS ON I-STAT ARE POTENTIALLY RELATED TO A HETEROPHILIC ANTIBODY BUT UNCONFIRMED AT THIS TIME. THE CUSTOMER STATED THAT THE PATIENT WAS NOT PREGNANT AND WAS REFERRED TO GYNECOLOGIST. THE REPORTING DECISION WAS BASED ON INFORMATION AVAILABLE THAT SUGGESTS THE PRODUCT WAS NOT PERFORMING WITHIN THE VARIABILITY OF THE ASSAY. THE INVESTIGATION IS UNDERWAY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
61279 I-STAT B-HCG CARTRIDGE B-HCG CARTRIDGE DHA ABBOTT POINT OF CARE NA F18331 10054749001009

Patients

Seq Age Sex Outcome Treatment
1 30 YR