IMMULITE 2000 ACTH N/A L2KAC2

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 2012-02-07 for IMMULITE 2000 ACTH N/A L2KAC2 manufactured by Siemens Healthcare Diagnostics.

Event Text Entries

[19929526] Discordant immulite 2000 acth results were generated on one patient sample. The laboratory repeated the sample and the repeat results confirmed patient value from previous month. A corrected report was sent to the physician. A second sample was also found to be low, it was repeated and a corrected report sent out. There was no known report of treatment given or withheld based on the discordant acth results.
Patient Sequence No: 1, Text Type: D, B5


[20278813] A siemens fse (field service engineer) was dispatched and contacted the customer. The customer declined service as they stated that the discordant results were due to a sample mixing issue. 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 Number2432235-2012-00033
MDR Report Key2441445
Report Source05,06
Date Received2012-02-07
Date of Report2012-01-13
Date of Event2012-01-13
Date Mfgr Received2012-01-13
Date Added to Maude2012-08-14
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 StreetGLYN RHONWY LLANBERIS
Manufacturer CityCAERNAFON, GWYNEDD,, WALES LL554EL
Manufacturer CountryUK
Manufacturer Postal CodeLL55 4EL
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameIMMULITE 2000 ACTH
Generic NameACTH IMMUNO-ASSAY
Product CodeCKG
Date Received2012-02-07
Model NumberN/A
Catalog NumberL2KAC2
Lot Number243/241
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS
Manufacturer AddressGLYN RHONWY LANNBERIS CAERNAFON, GWYNEDD,, WALES LL554EL UK LL55 4EL


Patients

Patient NumberTreatmentOutcomeDate
10 2012-02-07

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