MAUDE MDR 2165565

MDR report key
2165565
Report number
1415939-2011-00515
Event key
0
Event type
3
Date of event
2011-07-11
Date received
2011-07-17
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
NOEMI ROMERO-KONDOS, RN BSN
Address
100 ABBOTT PARK ROAD DEPT. 09B9, LCCP1-3 ABBOTT PARK IL 60064 US
Phone
847-847-8479
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1ARCHITECT C-PEPTIDE REAGENTABBOTT LABORATORIESJKD3L53-2503610K000N Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12011-07-170

Event Narratives#

D

Patient 1

THE ARCHITECT C-PEPTIDE ASSAY IS A CHEMILUMINESCENT MICROPARTICLE ASSAY FOR THE QUANTITATIVE DETERMINATION OF C-PEPTIDE IN HUMAN SERUM, PLASMA AND URINE AND IS USED AS AN AID IN THE DIAGNOSIS AND TREATMENT OF PATIENTS WITH ABNORMAL INSULIN SECRETION INCLUDING DIABETES MELLITUS. DURING A COMPLAINT INVESTIGATION, A PRODUCT DEFICIENCY WAS IDENTIFIED FOR ARCHITECT C-PEPTIDE REAGENTS, LIST # 3L53-25, LOTS 03610K000 AND 01711A000, WHICH HAVE THE POTENTIAL TO GENERATE FALSELY ELEVATED RESULTS WITH CERTAIN PATIENT SAMPLES AND NON-ABBOTT QUALITY CONTROLS. ABBOTT CONTROLS DO NOT EXHIBIT THIS SHIFT. A PRODUCT RECALL WAS ISSUED AND REPORTED UNDER 21CFR806 FOR THE ARCHITECT C-PEPTIDE REAGENT TO THE (B)(4) DISTRICT ON (B)(4) 2011. ABBOTT HAS NOT RECEIVED ANY REPORTS OF ADVERSE EVENTS RELATED TO THIS ISSUE.

N

Patient 1

SUSPECT MEDICAL DEVICE, LOT #: ADDITIONAL SUSPECT LOTS: 01711A000, MANUFACTURE DATE: (B)(4) 2011, EXPIRATION DATE: 12/12/11, (B)(4), MANUFACTURE DATE: (B)(4) 2011, EXPIRATION DATE: 10/29/11, (B)(4), MANUFACTURE DATE: (B)(4) 11, EXPIRATION DATE: 1/10/12, (B)(4), MANUFACTURE DATE: (B)(4) 2011, EXPIRATION DATE: 4/16/12. PATIENT: NO CONSEQUENCES OR IMPACT TO PATIENT (B)(4); (B)(4). DEVICE: HIGH TEST RESULTS (B)(4); (B)(4) THE CAUSE OF THE ARCHITECT C-PEPTIDE FALSELY ELEVATED QUALITY CONTROL AND PATIENT RESULTS WAS DUE TO A NEW ANTIBODY LOT USED IN THE MANUFACTURING OF THE C-PEPTIDE MICROPARTICLE AND/OR CONJUGATE REAGENTS. ABBOTT ISSUED A PRODUCT RECALL LETTER TO ALL CUSTOMERS WITH INSTRUCTIONS TO DISCARD AND DESTROY ANY REMAINING INVENTORY OF THE AFFECTED LOTS.

N

Patient 1

(B)(4).