IMMULITE 2000 N/A 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 2011-04-11 for IMMULITE 2000 N/A 030002 manufactured by Siemens Healthcare Diagnostics.

Event Text Entries

[22093442] Multiple discordant high immulite 2000 ins and tsh results were generated for multiple patients. One patient ((b)(6) boy) with a discordant high tsh result was kept overnite in the hospital for further testing. No medical procedure was performed on the boy. The laboratory repeated the samples and the repeat results were reported to the physician(s). There was no known report of treatment given or withheld based on the discordant ins and tsh results.
Patient Sequence No: 1, Text Type: D, B5


[22256383] A siemens fse (field service engineer) analyzed the immulite 2000 instrument and instrument data. Analysis of the instrument and instrument data indicated that the cause for the discordant ins and tsh results was due to a malfunction of the water pump. The water pump was replaced. The instrument is performing within specifications. No further evaluation of the device is required.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2247117-2011-00021
MDR Report Key2049045
Report Source05,06
Date Received2011-04-11
Date of Report2011-03-17
Date of Event2011-03-16
Date Mfgr Received2011-03-17
Date Added to Maude2012-03-12
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 ContactLINDA BARLETTA
Manufacturer Street511 BENEDICT AVENUE
Manufacturer CityTARRYTOWN NY 10591
Manufacturer CountryUS
Manufacturer Postal10591
Manufacturer Phone9145242299
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS
Manufacturer Street62 FLANDERS BARTLEY ROAD
Manufacturer CityFLANDERS NJ 07836
Manufacturer CountryUS
Manufacturer Postal Code07836
Single Use3
Remedial ActionRP
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameIMMULITE 2000
Generic NameIMMUNO-ASSAY
Product CodeDGC
Date Received2011-04-11
Model NumberN/A
Catalog Number030002
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS
Manufacturer AddressFLANDERS NJ 07835 US 07835


Patients

Patient NumberTreatmentOutcomeDate
10 2011-04-11

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