MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2012-03-08 for ADVIA 2120 N/A manufactured by Siemens Healthcare Diagnostics, Inc..
[2551300]
A discordant low hemoglobin result was obtained on the advia 2120 for one patient, the result was sent to the physician and the patient was hospitalized. The sample was repeated at the hospital and a corrected report was sent out, no patient treatment given. There is no known report of adverse health consequences due to the discordant hemoglobin result.
Patient Sequence No: 1, Text Type: D, B5
[9671312]
A siemens global product support specialist evaluated the advia 2120 instrument data and found that the cause of the discordant hemoglobin result was unknown. The instrument is performing within specifications. No further evaluation of the device is required.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 2432235-2012-00057 |
| MDR Report Key | 2483746 |
| Report Source | 05,06 |
| Date Received | 2012-03-08 |
| Date of Report | 2012-02-22 |
| Date of Event | 2012-02-17 |
| Date Mfgr Received | 2012-02-22 |
| Device Manufacturer Date | 2006-10-14 |
| Date Added to Maude | 2012-08-28 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | MINDY LOSAPIO |
| Manufacturer Street | 511 BENEDICT AVENUE |
| Manufacturer City | TARRYTOWN NY 10591 |
| Manufacturer Country | US |
| Manufacturer Postal | 10591 |
| Manufacturer Phone | 9145242312 |
| Manufacturer G1 | SIEMENS HEALTHCARE DIAGNOSTIC MANUFACTURING LTD |
| Manufacturer Street | CHAPEL LANE |
| Manufacturer City | SWORDS, DUBLIN |
| Manufacturer Country | EI |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ADVIA 2120 |
| Generic Name | HEMATOLOGY ANALYZER |
| Product Code | GKL |
| Date Received | 2012-03-08 |
| Model Number | ADVIA 2120 |
| Catalog Number | N/A |
| Lot Number | N/A |
| ID Number | N/A |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | SIEMENS HEALTHCARE DIAGNOSTICS, INC. |
| Manufacturer Address | 511 BENEDICT AVENUE TARRYTOWN NY 10591 US 10591 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Hospitalization | 2012-03-08 |