VITROS CHEMISTRY PRODUCTS GENT REAGENT 6801711

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 00,01,05 report with the FDA on 2013-01-04 for VITROS CHEMISTRY PRODUCTS GENT REAGENT 6801711 manufactured by Ortho-clinical Diagnostics.

Event Text Entries

[3064579] A customer observed multiple non-reproducible, higher than expected vitros gent quality control results (qc fluid biorad 2= 17. 20 vs. An expected result= 13. 09 mol/l; qc fluid biorad 3= 21. 58 vs. An expected result= 16. 57 mol/l) on a vitros 5,1 fs chemistry system. Biased results of the magnitude and direction observed may lead to inappropriate physician action if patient samples were affected. No patient samples were run during the time frame of the event. There was no report of patient harm as a result of this event. This report is number one of two mdrs for this event. Two 3500a forms are being submitted for this event as two devices were involved. (b)(4).
Patient Sequence No: 1, Text Type: D, B5


[10467126] The investigation determined that multiple non-reproducible, higher than expected vitros gent quality control results were obtained on a vitros 5,1 fs chemistry system. The investigation was unable to determine a definitive root cause. However, an instrument or reagent related issue, the biorad quality control fluids in use and the vitros gent calibration curve in use at the time of the event cannot be ruled out as potential contributing factors. Expected quality control results were obtained following recalibration of the same reagent lot. Further investigative actions were attempted. However, the customer did not wish to investigate further. The root cause of this event is unknown.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1319808-2013-00002
MDR Report Key2897556
Report Source00,01,05
Date Received2013-01-04
Date of Report2013-01-04
Date of Event2012-12-06
Date Mfgr Received2012-12-07
Device Manufacturer Date2012-05-24
Date Added to Maude2013-03-28
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationMEDICAL TECHNOLOGIST
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactMR. JOSEPH FALVO
Manufacturer Street100 INDIGO CREEK DRIVE
Manufacturer CityROCHESTER NY 14626
Manufacturer CountryUS
Manufacturer Postal14626
Manufacturer Phone5854533000
Manufacturer G1ORTHO-CLINICAL DIAGNOSTICS
Manufacturer Street1000 LEE ROAD
Manufacturer CityROCHESTER NY 14606
Manufacturer CountryUS
Manufacturer Postal Code14606
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameVITROS CHEMISTRY PRODUCTS GENT REAGENT
Generic NameIN-VITRO DIAGNOSTIC
Product CodeLCD
Date Received2013-01-04
Catalog Number6801711
Lot Number1512-08-2210
Device Expiration Date2014-02-28
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerORTHO-CLINICAL DIAGNOSTICS
Manufacturer Address100 INDIGO CREEK DRIVE ROCHESTER NY 14626 US 14626


Patients

Patient NumberTreatmentOutcomeDate
10 2013-01-04

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