COBAS 6000 E601 MODULE 04745922001

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06,07 report with the FDA on 2010-12-01 for COBAS 6000 E601 MODULE 04745922001 manufactured by Roche Diagnostics.

Event Text Entries

[1811952] The customer failed one external proficiency survey sample for the mb isoenzyme of creatinine kinase (ck-mb) and had been experiencing ck-mb quality control problems. The customer repeated the survey sample on the same cobas 6000 e601 module. The initial survey sample result generated by the customer was 54. 1 ng/ml. The survey sample mean was 64 ng/ml. The survey sample result when repeated was 62 ng/ml. The dates of initial and repeat testing were not provided by the customer. The ck-mb reagent lot number was not provided by the customer. The field service representative determined misadjusted high voltage on measuring cell #2 was the cause. He adjusted the voltage which resolved the issue. He performed calibrations and quality control which were acceptable.
Patient Sequence No: 1, Text Type: D, B5


[8807149] The survey sample was repeated a second time and recovered 64. 7 ng/ml. The date of testing was not provided by the customer.
Patient Sequence No: 1, Text Type: N, H10


[8909237] .
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1823260-2010-07065
MDR Report Key1911500
Report Source05,06,07
Date Received2010-12-01
Date of Report2010-12-21
Date of Event2010-11-11
Date Mfgr Received2010-11-11
Date Added to Maude2011-04-07
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 Location3
Manufacturer ContactNA ERIC KOLODZIEJ
Manufacturer Street9115 HAGUE ROAD NA
Manufacturer CityINDIANAPOLIS IN 46250
Manufacturer CountryUS
Manufacturer Postal46250
Manufacturer Phone3175212834
Manufacturer G1HITACHI HIGH TECH CORP.
Manufacturer Street882 ICHIGE HITACHINAKA NA
Manufacturer CityIBARAKI 312-8504
Manufacturer Postal Code312-8504
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameCOBAS 6000 E601 MODULE
Generic NameIMMUNOCHEMISTRY ANALYZER
Product CodeJHS
Date Received2010-12-01
Model NumberNA
Catalog Number04745922001
Lot NumberNA
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerROCHE DIAGNOSTICS
Manufacturer Address9115 HAGUE ROAD NA INDIANAPOLIS IN 46250 US 46250


Patients

Patient NumberTreatmentOutcomeDate
10 2010-12-01

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