IMMULITE 2000 030002

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2010-10-28 for IMMULITE 2000 030002 manufactured by Siemens Healthcare Diagnostics Inc..

Event Text Entries

[20942773] Two (2) discordant low immulite 2000 ipth (pth) results were obtained on different pt samples. The lab questioned the results since they were low and they repeated both samples. The discordant low ipth results were not reported to the physician. Pt treatment was not altered or prescribed. There was no report of adverse health consequences due to the discordant ipth results.
Patient Sequence No: 1, Text Type: D, B5


[21224131] A siemens healthcare technical service engineer (tse) evaluated the instrument data. Analysis of the instrument data indicate that the cause for the discordant pth results is unk. The instrument is performing within specifications. No further eval of the device is required.
Patient Sequence No: 1, Text Type: N, H10


[21063108] Two (2) discordant low immulite 2000 ipth (pth) results were obtained on different pt samples. The lab questioned the results since they were low and they repeated both samples. The discordant low ipth results were not reported to the physician. Pt treatment was not altered or prescribed. There was no report of adverse health consequences due to the discordant ipth results.
Patient Sequence No: 2, Text Type: D, B5


[21514516] A siemens healthcare technical service engineer (tse) evaluated the instrument data. Analysis of the instrument data indicate that the cause for the discordant pth results is unk. The instrument is performing within specifications. No further eval of the device is required.
Patient Sequence No: 2, Text Type: N, H10


MAUDE Entry Details

Report Number2247117-2010-00048
MDR Report Key1889087
Report Source05,06
Date Received2010-10-28
Date of Report2010-10-05
Date of Event2010-10-04
Date Mfgr Received2010-10-05
Date Added to Maude2011-04-19
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactLINDA BARLETTA
Manufacturer Street511 BENEDICT AVE.
Manufacturer CityTARRYTOWN NY 10591
Manufacturer CountryUS
Manufacturer Postal10591
Manufacturer Phone9145242299
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS, INC.
Manufacturer Street62 FLANDERS-BARTLEY RD.
Manufacturer CityFLANDERS NJ 07836
Manufacturer CountryUS
Manufacturer Postal Code07836
Single Use3
Remedial ActionOT
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameIMMULITE 2000
Generic NameIMMUNO-ASSAY
Product CodeDGC
Date Received2010-10-28
Model NumberNA
Catalog Number030002
Lot NumberNA
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeNA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS INC.
Manufacturer AddressFLANDERS NJ 07835 US 07835


Patients

Patient NumberTreatmentOutcomeDate
10 2010-10-28
20 2010-10-28

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