MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2009-09-15 for IMMULITE 2000 030002 manufactured by Siemens Healthcare Diagnostics Inc.
[1130979]
Discordant acth result was obtained on a pt sample, generated on an immulite 2000. The sample was repeated and the result was reported. Pt treatment was not altered or prescribed. There was no report of adverse health consequences as a result of the discordant acth result.
Patient Sequence No: 1, Text Type: D, B5
[8313514]
A siemens healthcare technical support engineer (tse) analyzed the instrument data and determined that the cause of the discordant result was due to the reagent level sense error. The cause of the reagent level sense error is unk. The instrument is performing within specs. No further eval of the device is required.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 2247117-2009-00034 |
| MDR Report Key | 1478401 |
| Report Source | 05,06 |
| Date Received | 2009-09-15 |
| Date of Report | 2009-08-14 |
| Date of Event | 2009-08-13 |
| Date Mfgr Received | 2009-08-14 |
| Date Added to Maude | 2011-03-21 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | LINDA BARLETTA |
| Manufacturer Street | 511 BENEDICT AVE |
| Manufacturer City | TARRYTOWN NY 10591 |
| Manufacturer Country | US |
| Manufacturer Postal | 10591 |
| Manufacturer Phone | 9145242299 |
| Manufacturer G1 | SIEMENS HEALTHCARE DIAGNOSTICS INC |
| Manufacturer Street | 62 FLANDERS BARTLEY RD. |
| Manufacturer City | FLANDERS NJ 07836 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 07836 |
| Single Use | 3 |
| Remedial Action | IN |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | IMMULITE 2000 |
| Generic Name | IMMUNO-ASSAY ANALYZER |
| Product Code | CKG |
| Date Received | 2009-09-15 |
| Model Number | NA |
| Catalog Number | 030002 |
| Lot Number | NA |
| ID Number | NA |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | NA |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | SIEMENS HEALTHCARE DIAGNOSTICS INC |
| Manufacturer Address | FLANDERS NJ 07836 US 07836 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2009-09-15 |