RHEUMATOID FACTOR REAGENT 447070

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 2012-02-14 for RHEUMATOID FACTOR REAGENT 447070 manufactured by Beckman Coulter, Inc..

Event Text Entries

[2435547] Customer reported to beckman coulter, inc. (bec) that false positive rheumatoid factor (rf) patient results were generated when rheumatoid factor reagent lot number m008778 was used on the immage immunochemistry system. Customer reported that negative results were obtained when the tests were re-run with a different lot of rf reagent. Customer reported that erroneous results were not reported out of the laboratory. There was no report of any adverse event or injury requiring medical intervention or patient treatment.
Patient Sequence No: 1, Text Type: D, B5


[9635847] Erroneous rheumatoid factor results were generated on four different days. This report is one of four reports related to four events that occurred on four different days. This report is related to mdr#2050010-2012-00001, 2050010-2012-00002, 2050010-2012-00003.
Patient Sequence No: 1, Text Type: N, H10


[14885334] This follow up report is being submitted to correct an error in the original report. Correction: the erroneous results were reported out of the laboratory; however, patient treatment was not affected.
Patient Sequence No: 1, Text Type: D, B5


[15298708] This is a follow up report.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2050010-2012-00004
MDR Report Key2451813
Report Source01,05,06
Date Received2012-02-14
Date of Report2012-01-17
Date of Event2012-01-04
Date Mfgr Received2012-05-15
Device Manufacturer Date2010-12-16
Date Added to Maude2012-08-16
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 ContactMS. DUNG NGUYEN
Manufacturer Street250 S. KRAEMER BLVD.
Manufacturer CityBREA CA 92821
Manufacturer CountryUS
Manufacturer Postal92821
Manufacturer Phone7149613634
Manufacturer G1BECKMAN COULTER, INC.
Manufacturer Street2470 FARADAY AVENUE
Manufacturer CityCARLSBAD CA 92010
Manufacturer CountryUS
Manufacturer Postal Code92010
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameRHEUMATOID FACTOR REAGENT
Generic NameSYSTEM, TEST, RHEUMATOID FACTOR
Product CodeDHR
Date Received2012-02-14
Catalog Number447070
Lot NumberM008778
Device Expiration Date2012-12-31
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerBECKMAN COULTER, INC.
Manufacturer Address2470 FARADAY AVENUE CARLSBAD CA 92010 US 92010


Patients

Patient NumberTreatmentOutcomeDate
10 2012-02-14

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