MAUDE MDR 2853431

MDR report key
2853431
Report number
2122870-2012-01941
Event key
0
Event type
3
Date of event
2012-10-28
Date received
2012-11-30
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
100
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
MS. DUNG NGUYEN
Address
250 S KRAEMER BLVD. BREA CA 92821 US
Phone
714-714-7149
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1UNICEL? DXL 600 ACCESS? IMMUNOASSAY SYSTEMANALYZER, CHEMISTRY (PHOTOMETRIC, DISCRETE), FOR CLINICAL USEBECKMAN COULTER INC.JLBNAA71461NAY Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12012-11-300

Event Narratives#

D

Patient 1

A CUSTOMER CONTACTED BECKMAN COULTER INC., (BEC) AND REPORTED MULTIPLE OCCURRENCES OF ERRONEOUS AND/OR IMPRECISE CREATINE KINASE-MB (CK-MB) RESULTS ON TWO PATIENT SAMPLES TESTED ON UNICEL DXL 600 ACCESS IMMUNOASSAY SYSTEM. THIS REPORT IS TO DOCUMENT CKMB RESULTS FOR PATIENT # 1. CUSTOMER INDICATED THE PATIENT SAMPLE WAS TESTED TWICE. THE RESULTS EXHIBITED IMPRECISION OUTSIDE SPECIFICATION, AND BOTH THE ORIGINAL AND THE REPEAT RESULT WERE ABOVE THE NORMAL REFERENCE RANGE. THE CUSTOMER'S QC WAS WITHIN THE LABORATORY'S ESTABLISHED LIMITS BEFORE THE EVENT. NO OTHER CK-MB RESULTS OR OTHER ASSAYS WERE IN QUESTION. THE CUSTOMER STATED NO ERRONEOUS RESULTS WERE REPORTED OUTSIDE THE LABORATORY. THE CUSTOMER DID NOT REPORT AN EFFECT TO PATIENT OR USER ATTRIBUTED OR CONNECTED TO THIS EVENT. MDR #: 2122870-2012-01942 IS BEING SUBMITTED FOR PATIENT # 2.

N

Patient 1

THE LABORATORY UTILIZES 5ML BD LITHIUM HEPARIN PLASMA SEPARATOR TUBES WITH GEL FOR CK-MB SAMPLE COLLECTIONS. THE CUSTOMER CENTRIFUGES CK-MB SAMPLES FOR 3 MINUTES AT AMBIENT TEMPERATURE IN A STAT SPAN EXPRESS 4 CENTRIFUGE. THE CUSTOMER DECLINED TO PROVIDE CENTRIFUGATION SPEED. PER CUSTOMER, THE SAMPLE WAS PROCESSED WITHIN ONE HOUR OF COLLECTION. THE CUSTOMER PROVIDED SYSTEM CHECK DATA FROM (B)(6) 2012; ALL SYSTEM CHECK PARAMETERS WERE PASSING WITHIN SPECIFICATIONS. NO EVENT LOG MESSAGES WERE GENERATED IN CONNECTION WITH THIS EVENT. A BEC FIELD SERVICE ENGINEER (FSE) WAS DISPATCHED TO THE CUSTOMER'S SITE. THE FSE ADJUSTED PIPETTOR TEMPERATURES AND VERIFIED PIPETTOR ALIGNMENTS. THE FSE PERFORMED A SYSTEM CHECK AND HIGH SENSITIVITY SYSTEM CHECK; BOTH SYSTEM CHECKS PASSED FOR ALL PARAMETERS WITHIN SPECIFICATION. THE FSE VERIFIED THAT CK-MB PRECISION WAS WITHIN SPECIFICATION AND VERIFIED THAT THE CUSTOMER'S QC WAS WITHIN THE LABORATORY'S ESTABLISHED LIMITS. THE INSTRUMENT WAS VERIFIED AS PERFORMING TO PUBLISHED PERFORMANCE SPECIFICATIONS. A CAUSE FOR THIS EVENT COULD NOT BE DETERMINED WITH THE INFORMATION SUPPLIED.