ADVIA CENTAUR XP CORTISOL (COR) ASSAY N/A 04610138

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 2012-03-16 for ADVIA CENTAUR XP CORTISOL (COR) ASSAY N/A 04610138 manufactured by Siemens Healthcare Diagnostics, Inc..

Event Text Entries

[2541347] The customer has observed accumulation of solid phase particles lines on the sides of the advia centaur xp cortisol reagent ready packs and failed quality control results within onboard stability. The siemens technical application specialist (tas) mixed the reagent pack and the quality control was within range. There was no report of adverse health consequences due to the failed onboard cortisol quality control results.
Patient Sequence No: 1, Text Type: D, B5


[9697608] Siemens has investigated and confirmed the customer's observation of reagent pack solid phase banding (lines) that affects the onboard stability of the reagents which has the potential to affect both controls and patient results over the onboard stability period. An urgent field safety notice ((b)(4)) was distributed to customers in (b)(6) 2012 to address this issue.
Patient Sequence No: 1, Text Type: N, H10


[10436971] (b)(4).
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1219913-2012-00132
MDR Report Key2494502
Report Source05,06
Date Received2012-03-16
Date of Report2011-12-19
Date of Event2011-12-15
Date Mfgr Received2013-02-06
Date Added to Maude2012-03-27
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactMR. STEPHEN PERRY
Manufacturer Street333 CONEY ST.
Manufacturer CityEAST WALPOLE MA 02032
Manufacturer CountryUS
Manufacturer Postal02032
Manufacturer Phone5086604163
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS, INC.
Manufacturer Street333 CONEY STREET
Manufacturer CityEAST WALPOLE MA 02032
Manufacturer CountryUS
Manufacturer Postal Code02032
Single Use3
Remedial ActionIN
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameADVIA CENTAUR XP CORTISOL (COR) ASSAY
Generic NameCORTISOL IMMUNOASSAY
Product CodeJFT
Date Received2012-03-16
Model NumberN/A
Catalog Number04610138
Lot Number254
Device Expiration Date2012-05-23
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS, INC.
Manufacturer AddressTARRYTOWN NY 10591 US 10591


Patients

Patient NumberTreatmentOutcomeDate
10 2012-03-16

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