MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2013-04-02 for VITROS CHEMISTRY PRODUCTS PHBR SLIDES 8221384 manufactured by Ortho-clinical Diagnostics.
[3257437]
The customer obtained a non-reproducible, lower than expected vitros phbr quality control result using a vitros 5600 integrated system. The following result was obtained: vitros phbr gen 41 qc fluid = 51. 04 vs. Expected result = 77 ng/ml; biased results of the direction and magnitude observed may lead to inappropriate physician action if they were to occur undetected on patient samples. No vitros phbr patient results were reported to the physician during the time frame of the event. There was no report of patient harm as a result of this event. (b)(4).
Patient Sequence No: 1, Text Type: D, B5
[10652878]
The investigation confirmed that a non-reproducible, lower than expected vitros phbr quality control result was predicted while using the vitros 5600 integrated system. Expected performance was obtained using on a subsequent run using the same reagent pack. The investigation could not determine a definitive root cause.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 1319809-2013-00128 |
| MDR Report Key | 3030148 |
| Report Source | 05 |
| Date Received | 2013-04-02 |
| Date of Report | 2013-04-02 |
| Date of Event | 2013-02-02 |
| Date Mfgr Received | 2013-03-04 |
| Device Manufacturer Date | 2013-02-03 |
| Date Added to Maude | 2013-05-31 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | MEDICAL TECHNOLOGIST |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | MR. JOSEPH FALVO |
| Manufacturer Street | 100 INDIGO CREEK DRIVE |
| Manufacturer City | ROCHESTER NY 14626 |
| Manufacturer Country | US |
| Manufacturer Postal | 14626 |
| Manufacturer Phone | 5854533000 |
| Manufacturer G1 | ORTHO-CLINICAL DIAGNOSTICS |
| Manufacturer Street | 513 TECHNOLOGY BLVD. |
| Manufacturer City | ROCHESTER NY 14652 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 14652 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | VITROS CHEMISTRY PRODUCTS PHBR SLIDES |
| Generic Name | IN-VITRO DIAGNOSTIC |
| Product Code | DLZ |
| Date Received | 2013-04-02 |
| Catalog Number | 8221384 |
| Lot Number | 2541-0064-1256 |
| Device Expiration Date | 2014-02-01 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ORTHO-CLINICAL DIAGNOSTICS |
| Manufacturer Address | 100 INDIGO CREEK DRIVE ROCHESTER NY 14626 US 14626 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2013-04-02 |