MAUDE MDR 3147383

MDR report key
3147383
Report number
1823260-2013-03388
Event key
0
Event type
3
Date of event
2013-05-11
Date received
2013-06-05
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
105
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
NA JENNIFER WOLFGRAM
Address
9115 HAGUE ROAD NA INDIANAPOLIS IN 46250 US
Phone
317-317-3175
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1COBAS 6000 E601 MODULEIMMUNOCHEMISTRY ANALYZERROCHE DIAGNOSTICSJLBNA04745922001NAR Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12013-06-050

Event Narratives#

D

Patient 1

THE CUSTOMER RECEIVED ANALYZER ALARMS AND DISCOVERED QUESTIONABLE RESULTS FOR CK-MB, TROPONIN I AND N-TERMINAL PRO B-TYPE NATRIURETIC PEPTIDE (PRO-BNP) FOR AN UNKNOWN NUMBER OF PATIENT SAMPLES. OF THE DATA PROVIDED, ONLY THE RESULTS FOR THE FOLLOWING FOUR PATIENT SAMPLES WERE DISCREPANT AND REPORTED OUTSIDE THE LABORATORY. PATIENT SAMPLE 1 INITIAL TROPONIN I RESULT WAS 25.00 NG/ML WITH A DATA FLAG. THE REPEAT RESULT ON THE SAME ANALYZER WITH A 1:10 DILUTION WAS 38.43 NG/ML WITH A DATA FLAG. THE SAMPLE WAS REPEATED ON COBAS E601 ANALYZER SERIAL NUMBER (B)(4) AND THE RESULT WAS 25.00 NG/ML WITH A DATA FLAG. THE REPEAT RESULT WITH A 1:10 DILUTION WAS 137.6 NG/ML. THE PATIENT WAS NOT ADVERSELY AFFECTED. PATIENT SAMPLE 2 WAS FROM A (B)(6) FEMALE PATIENT. THE INITIAL PRO- BNP RESULT WAS 56.65 PG/ML. THE REPEAT RESULT ON COBAS E601 ANALYZER SERIAL NUMBER (B)(4) ON (B)(6) 2013 WAS 157.1 PG/ML. THE REPEAT RESULT ON THE ORIGINAL COBAS E601 ANALYZER ON (B)(6) 2013 WAS 157.1 PG/ML. THE PATIENT WAS NOT ADVERSELY AFFECTED. PATIENT SAMPLE 3 WAS FROM A (B)(6) FEMALE PATIENT. THE INITIAL TROPONIN I RESULT ON COBAS E601 ANALYZER SERIAL NUMBER (B)(4) WAS 14.83 NG/ML WITH A DATA FLAG. ON (B)(6) 2013, THE SAMPLE WAS REPEATED ON COBAS E601 ANALYZER SERIAL NUMBER (B)(4) AND THE RESULT WAS 25.00 NG/ML WITH A DATA FLAG. THE REPEAT RESULT ON THE SAME ANALYZER WITH A 1:10 DILUTION WAS 48.69 NG/ML WITH A DATA FLAG. THE PATIENT WAS NOT ADVERSELY AFFECTED. PATIENT SAMPLE 4 WAS FROM A (B)(6) MALE PATIENT. THE INITIAL TROPONIN I RESULT WAS 1.89 NG/ML. THE REPEAT RESULT WAS

N

Patient 1

IT WAS UNKNOWN IF THE INITIAL REPORTER SENT REPORT TO THE FDA.