FDA Adverse Event Malfunction Summary report: N

BD SEDI-40

MDR report key: 8884766 · Received August 12, 2019

Report

Report Number
2243072-2019-01676
Event Type
Malfunction
Date Received
August 12, 2019
Date of Event
July 26, 2019
Report Date
September 5, 2019
Manufacturer
BECTON DICKINSON
Product Code
JKA
PMA / PMN Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PL
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

H.6. INVESTIGATION SUMMARY: BD RECEIVED THE INSTRUMENT FROM THE CUSTOMER FACILITY FOR INVESTIGATION. THE INSTRUMENT WAS TESTED/EVALUATED AND THE CUSTOMER'S INDICATED FAILURE MODE FOR INSTRUMENT REJECTS SAMPLES AS LLO WITH THE INCIDENT LOT WAS NOT OBSERVED AS THE INSTRUMENT WAS FUNCTIONING CORRECTLY, ALTHOUGH IT WAS EXPLAINED THAT IF TUBES ARE SIGNIFICANTLY OVERFILLED AN ERROR RESPONSE CAN BE GENERATED. H3 OTHER TEXT : SEE SECTION H.10.

Description of Event or Problem · 0

IT HAS BEEN REPORTED THAT THE BD SEDI-40 HAS BEEN FOUND EXPERIENCING HARDWARE/SOFTWARE MALFUNCTION DURING USE. THE FOLLOWING HAS BEEN PROVIDED BY THE INITIAL REPORTER: THE INSTRUMENT REJECTS THE SAMPLES AS LLO DESPITE THE TUBES ARE FILLED CORRECTLY. IT ALSO DID NOT READ QC RESULTS. QC RESULT (ZEROS) LLO ERROR MESSAGE TUBE FILL THE ERROR REPEATED TWICE ON DIFFERENT TUBES, SOCKETS 1 AND 2.

Additional Manufacturer Narrative · 1

THE MANUFACTURING LOCATION FOR THIS PRODUCT IS ELITECH. THIS SITE IS AN OEM MANUFACTURING SITE. THEREFORE, BD CORPORATE HEADQUARTERS IN (B)(4) HAS BEEN LISTED AND THE (B)(4) FDA REGISTRATION NUMBER HAS BEEN USED FOR THE MANUFACTURE REPORT NUMBER. MEDICAL DEVICE EXPIRATION DATE: UNKNOWN. A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS ANTICIPATED, BUT IS NOT COMPLETE. UPON COMPLETION, A SUPPLEMENTAL REPORT WILL BE FILED. DEVICE MANUFACTURE DATE: UNKNOWN.

Description of Event or Problem · 1

IT HAS BEEN REPORTED THAT THE BD SEDI-40 HAS BEEN FOUND EXPERIENCING HARDWARE/SOFTWARE MALFUNCTION DURING USE. THE FOLLOWING HAS BEEN PROVIDED BY THE INITIAL REPORTER: THE INSTRUMENT REJECTS THE SAMPLES AS LLO DESPITE THE TUBES ARE FILLED CORRECTLY. IT ALSO DID NOT READ QC RESULTS. QC RESULT (ZEROS). LLO ERROR MESSAGE. TUBE FILL. THE ERROR REPEATED TWICE ON DIFFERENT TUBES, SOCKETS 1 AND 2.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
679323 BD SEDI-40 ESR INSTRUMENT JKA BECTON DICKINSON UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Other