TOTAL PROTEIN GEN.2 03183734190

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 2011-05-23 for TOTAL PROTEIN GEN.2 03183734190 manufactured by Roche Diagnostics.

Event Text Entries

[1999991] The user stated they were receiving questionable total protein results on their cobas c501 (serial number (b)(4)). The user was able to provide data for ten patients. Of that data, there were two discrepant total protein results reported outside the laboratory. All repeats were performed on (b)(6) 2011 and sent out on corrected reports. The first patient had an initial result of 8. 7 g/dl. The repeat result was 7. 0 g/dl. The second patient, a male born on (b)(6), had an initial result of 1. 6 g/dl. The repeat result was 6. 9 g/dl. There were no adverse affects to the patients as a result of this event. The user declined a service visit. The user believed the problem was caused by a faulty probe that may have been partially occluded by gel. He changed the probe and there have been no further issues.
Patient Sequence No: 1, Text Type: D, B5


[9016528] The cause of this event was determined to be customer handling of sample tubes. The customer was contacted regarding proper handling of sample tues, not placing taller sample tubes into racks dedicated to be used with shorter tubes, and pouring short samples into sample cups for testing.
Patient Sequence No: 1, Text Type: N, H10


[9053566] (b)(6).
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1823260-2011-02719
MDR Report Key2098718
Report Source05,06
Date Received2011-05-23
Date of Report2011-06-17
Date of Event2011-04-20
Date Mfgr Received2011-04-29
Date Added to Maude2011-05-23
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 116 NA
Manufacturer CityMANNHEIM (BADEN-WURTTEMBERG) 68305
Manufacturer Postal Code68305
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameTOTAL PROTEIN GEN.2
Generic NameBIURET (COLORIMETRIC), TOTAL PROTEIN
Product CodeCEK
Date Received2011-05-23
Model NumberNA
Catalog Number03183734190
Lot Number63701701
ID NumberNA
Device Expiration Date2012-03-31
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
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 2011-05-23

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