C-REACTIVE PROTEIN (LATEX) 20764930322

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01,05,06 report with the FDA on 2011-05-09 for C-REACTIVE PROTEIN (LATEX) 20764930322 manufactured by Roche Diagnostics.

Event Text Entries

[2027338] The user received questionable c-reactive protein (crp) results for two samples from one patient on the cobas integra 400 plus analyzer serial number (b)(4) when compared to the results from the cobas c701 analyzer tested approximately three days later. Sample 1 result from the integra was 2936. 4 mg/l and the result from the cobas c701 was 2. 41 mg/l. On (b)(6) 2011, sample 2 result from the integra was 2918. 0 mg/l and the result from the cobas c701 was 18. 4 mg/l. No adverse events were alleged regarding the issue. The doctor stated the crp results from the cobas c701 reveal the correct values as the patient leucocytes and interleukin 6 results were within the normal range.
Patient Sequence No: 1, Text Type: D, B5


[9105482] This event occurred in (b)(6).
Patient Sequence No: 1, Text Type: N, H10


[9275220] The investigation confirmed the deviations in crp results between the analyzers. The crp reagent for the integra differs from the crp reagent for the cobas c701, which might be a reason for the observed difference in the results. During testing of the patient's samples, extremely elevated igm results and a kappa/lambda ratio outside the normal range were discovered. These results indicate a monoclonal gammopathy which is a documented limitation mentioned in product labeling for the assay. The turbidity principle of the crp latex agglutination test is strongly interfered with by other proteins in the sample, which may cause additional turbidities. Crp measurements will be repeated several times in symptomatic patients. Results should always be evaluated in context with the patient's clinical status and additional laboratory parameters such as leukocyte count, procalcitonin etc.
Patient Sequence No: 1, Text Type: N, H10


[9287835] Additional information was received concerning the patient. The patient diagnoses were: "embolic ischemia, ineffective anticoagulation, hypertensive, diabetes mellitus type ii, colon resection. " the patient medications were: "digitoxin 0. 07 mg 1-0-0, delix 5 plus 1- 0-1, beloe zok 1-0-1, amlodipin 5 mg 1-0-1, atacand 32 mg 1-0-1, ebrantil 60 mg 1-0-1, janumet 50/1000 1-0-1, finamed 5 mg 0-0-1, simvastatin 40 mg 0-0-1, lantus 0-00-44, ie insulins rapid after bz sohema. "
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1823260-2011-02462
MDR Report Key2081161
Report Source01,05,06
Date Received2011-05-09
Date of Report2011-08-02
Date of Event2011-04-06
Date Mfgr Received2011-04-19
Date Added to Maude2011-05-09
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 RAE ANN FARROW
Manufacturer Street9115 HAGUE ROAD NA
Manufacturer CityINDIANAPOLIS IN 46250
Manufacturer CountryUS
Manufacturer Postal46250
Manufacturer Phone3175213194
Manufacturer G1ROCHE DIAGNOSTICS GMBH
Manufacturer StreetSANDHOFERSTRASSE 118 NA
Manufacturer CityMANNHEIM (BADEN-WURTTEMBERG) 68300
Manufacturer Postal Code68300
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameC-REACTIVE PROTEIN (LATEX)
Generic NameSYSTEM, TEST, C-REACTIVE PROTEIN
Product CodeDCN
Date Received2011-05-09
Model NumberNA
Catalog Number20764930322
Lot Number639215
ID NumberNA
Device Expiration Date2010-11-30
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerROCHE DIAGNOSTICS
Manufacturer Address9118 HAGUE ROAD NA INDIANAPOLIS NA NA


Patients

Patient NumberTreatmentOutcomeDate
10 2011-05-09

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