MAUDE MDR 2468015

MDR report key
2468015
Report number
1415939-2012-00045
Event key
0
Event type
3
Date received
2012-02-24
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 INSULINABBOTT LABORATORIESCFP08K41-2609020LP36N Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12012-02-240

Event Narratives#

N

Patient 1

PRODUCT EVALUATION WAS PERFORMED TO INVESTIGATE THIS ISSUE. THE LOT SEARCH DETERMINED THAT THERE IS NO UNUSUAL ACTIVITY FOR THE LIKELY CAUSE LOT AND THE TREND REVIEW DETERMINED THAT COMPLAINT ACTIVITY WAS NOT ATYPICAL FOR THE ISSUE UNDER INVESTIGATION. ADDITIONALLY, ACCURACY TESTING WAS COMPLETED USING LIKELY CAUSE LOT 09020LP36 AND FOUR PANELS WITH KNOWN CONCENTRATIONS OF INSULIN. ALL PANELS WERE WITHIN THE RESPECTIVE ACCEPTANCE RANGES. BASED ON THE RESULTS OF THIS INVESTIGATION, THE ARCHITECT INSULIN REAGENT LOT 09020LP30 IS PERFORMING AS INTENDED AND NO ADDITIONAL PRODUCT ISSUES WERE IDENTIFIED. NO DEFICIENCY WAS IDENTIFIED RELATED TO THE ALLEGED MALFUNCTION REPORTED BY THE CUSTOMER.

N

Patient 1

CORRECTION WAS ADDED (PRODUCT LOT NUMBER WAS CORRECTED FROM 09020LP30 TO 09020LP36).

N

Patient 1

THIS REPORT IS BEING SUBMITTED TO REFERENCE A PREVIOUS REPORT (3002809144-2012-00026) WHICH WAS PREVIOUSLY SUBMITTED UNDER THE INCORRECT MANUFACTURER SITE. (B)(4). PRODUCT EVALUATION IS IN PROCESS AND THE RESULTS WIL BE SUBMITTED IN A FOLLOW-UP REPORT.

D

Patient 1

THE CUSTOMER STATED THAT ONE PATIENT SAMPLE GENERATED A FALSELY ELEVATED RESULT FOR THE ARCHITECT INSULIN ASSAY. A RESULT OF 119.2 UU/ML WAS REPEATED AT 10.34 UU/ML USING A DIFFERENT (NON-ABBOTT) METHOD. THE PATIENT WAS MONITORED AND HAD A HISTORY OF INSULIN RESULTS AROUND 10 UU/ML. NO IMPACT TO PATIENT MANAGEMENT WAS REPORTED.