VITROS IMMUNODIAGNOSTIC PRODUCTS AHIV REAGENT PACK 1241850

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 00,01,05 report with the FDA on 2008-06-17 for VITROS IMMUNODIAGNOSTIC PRODUCTS AHIV REAGENT PACK 1241850 manufactured by Ortho-clinical Diagnostics.

Event Text Entries

[21990351] Investigation into this event found that a negative vitros result was obtained for a patient sample drawn from a reactive patient. The patient sample involved in this event is no longer available. A request has been made to obtain an additional sample from this patient for further testing at ortho-clinical diagnostics. The vitros eci analyzer was performing as expected. The root cause of this event unknown.
Patient Sequence No: 1, Text Type: N, H10


[22072882] A customer observed a reproducible negatively biased a result for a patient sample using the vitros eci. The patient results were not reported to the clinician. There was no report of patient harm as a result of this event. This report corresponds to ortho clinical diagnostics inc.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9680658-2008-00187
MDR Report Key1062975
Report Source00,01,05
Date Received2008-06-17
Date of Report2008-05-07
Date of Event2008-05-05
Date Mfgr Received2008-05-07
Device Manufacturer Date2007-11-01
Date Added to Maude2009-10-29
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactJOE FALVO
Manufacturer Street100 INDIGO CREEK DRIVE
Manufacturer CityROCHESTER NY 146265101
Manufacturer CountryUS
Manufacturer Postal146265101
Manufacturer Phone5854535735
Manufacturer G1FOREST FARM ESTATE
Manufacturer StreetWHITCHURCH
Manufacturer CityCARDIFF CF147YT
Manufacturer CountryUK
Manufacturer Postal CodeCF14 7YT
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameVITROS IMMUNODIAGNOSTIC PRODUCTS AHIV REAGENT PACK
Generic NameIN VITRO DIAGNOSTIC
Product CodeMTL
Date Received2008-06-17
Model NumberNA
Catalog Number1241850
Lot Number1942
ID NumberNA
Device Expiration Date2008-08-04
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerORTHO-CLINICAL DIAGNOSTICS
Manufacturer Address100 INDIGO CREEK DRIVE ROCHESTER NY 14626510 US 14626 5101


Patients

Patient NumberTreatmentOutcomeDate
10 2008-06-17

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