PRISM CHAGAS 07K35-68

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2012-05-18 for PRISM CHAGAS 07K35-68 manufactured by Abbott Laboratories.

Event Text Entries

[2716542] The customer observed false reactive chagas results while using the prism chagas assay. The customer provided the following results ((b)(6) 2012): initial 6. 38 s/co, retest 5. 13 s/co, 4. 99 s/co. The specimen was tested with the ripa method at another laboratory on (b)(6) 2012, it generated a negative result. There was no adverse impact to patient management reported.
Patient Sequence No: 1, Text Type: D, B5


[9928213] (b)(4). An evaluation is in process. A follow-up report will be submitted when the evaluation is complete.
Patient Sequence No: 1, Text Type: N, H10


[10226383] Further investigation of the customer issue included a review of the complaint text, in-house testing, a search for similar complaints, and a review of labeling. A specificity testing protocol was executed using lot 12503m500 and met acceptance criteria which determined the reagent is performing acceptably. Tracking and trending did not identify an adverse trend. Labeling was reviewed and found to be adequate. Based on the available information a deficiency of the prism chagas reagent list number 07k35, lot 12503m500, was not identified.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1415939-2012-00214
MDR Report Key2580311
Report Source05
Date Received2012-05-18
Date of Report2012-04-30
Date of Event2012-03-24
Date Mfgr Received2012-07-26
Device Manufacturer Date2012-01-01
Date Added to Maude2012-09-25
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 ContactNOEMI ROMERO-KONDOS, RN BSN
Manufacturer Street100 ABBOTT PARK ROAD DEPT. 09B9, LCCP1-3
Manufacturer CityABBOTT PARK IL 600643537
Manufacturer CountryUS
Manufacturer Postal600643537
Manufacturer Phone847937-512
Manufacturer G1ABBOTT LABORATORIES
Manufacturer Street100 ABBOTT PARK ROAD
Manufacturer CityABBOTT PARK IL 60064350
Manufacturer CountryUS
Manufacturer Postal Code60064 3500
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePRISM CHAGAS
Product CodeMIU
Date Received2012-05-18
Catalog Number07K35-68
Lot Number12503M500
Device Expiration Date2012-10-21
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerABBOTT LABORATORIES
Manufacturer Address100 ABBOTT PARK ROAD ABBOTT PARK IL 60064350 US 60064 3500


Patients

Patient NumberTreatmentOutcomeDate
10 2012-05-18

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