ADVIA CENTAUR XP FOLATE (FOL) ASSAY N/A 06891541

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 2012-07-19 for ADVIA CENTAUR XP FOLATE (FOL) ASSAY N/A 06891541 manufactured by Siemens Healthcare Diagnostics, Inc..

Event Text Entries

[10154802] (b)(4). A siemens field service engineer (fse) was sent to the customer site. The fse repaired tubing connections at the base dispense probe, replaced luminometer cover, and replaced probes. The quality control for the folate assay was run and was acceptable. Siemens performed an investigation and the internal data did not confirm the quality control bias or the patient bias that was observed by the customer for the folate assay prior to service.
Patient Sequence No: 1, Text Type: N, H10


[18414383] Low bias advia centaur xp folate results were observed by the customer with controls and patients when switching to reagent lot# 211. Patient treatment was not prescribed or altered. There was no report of adverse health consequences due to the discordant folate results.
Patient Sequence No: 1, Text Type: D, B5


[18679511] The cause for the discordant folate results is unknown. A siemen's representative was sent to the customer site. The siemen's representative performed testing using fresh reagents and the results were the same. Siemens healthcare diagnostics is investigating the cause of the discordant results.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1219913-2012-00277
MDR Report Key2662272
Report Source05,06
Date Received2012-07-19
Date of Report2012-06-20
Date of Event2012-06-20
Date Mfgr Received2012-08-23
Device Manufacturer Date2012-03-22
Date Added to Maude2012-11-09
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 ContactMS. EIMAN SULIEMAN
Manufacturer Street333 CONEY STREET
Manufacturer CityE. WALPOLE MA 02032
Manufacturer CountryUS
Manufacturer Postal02032
Manufacturer Phone5086604603
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS, INC.
Manufacturer Street333 CONEY STREET
Manufacturer CityE. 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 FOLATE (FOL) ASSAY
Generic NameFOLATE IMMUNOASSAY
Product CodeCGN
Date Received2012-07-19
Model NumberN/A
Catalog Number06891541
Lot Number211
ID NumberN/A
Device Expiration Date2012-12-22
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 2012-07-19

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