MAUDE MDR 3328001

MDR report key
3328001
Report number
2432235-2013-00428
Event key
0
Event type
3
Date of event
2013-08-12
Date received
2013-09-05
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
CASSANDRA KOCSIS
Address
511 BENEDICT AVENUE TARRYTOWN NY 10591 US
Phone
914-914-9145
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1ADVIA 1800CLINICAL CHEMISTRY ANALYZERSIEMENS HEALTHCARE DIAGNOSTICS INC.KXTADVIA 1800073-A021-01N N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12013-09-050

Event Narratives#

D

Patient 1

THREE PATIENT SAMPLES RESULTED FALSELY LOW AND ONE PATIENT SAMPLE RESULTED WITH SLASH-MARKS (/////) FOR DIGOXIN ON AN ADVIA 1800 INSTRUMENT. THE RESULTS WERE REPORTED TO THE PHYSICIAN(S). WHEN THE OPERATOR RERAN QUALITY CONTROLS (QC) FOR DIGOXIN AS SCHEDULED, THE QC WAS OUT OF RANGE. THE OPERATOR RECALIBRATED THE INSTRUMENT AND RERAN QC, WHICH WAS WITHIN RANGE. PATIENT SAMPLES TESTED PRIOR TO THE RECALIBRATION WERE THEN RUN, AND THE FOUR SAMPLES WERE DISCORDANT. THE CORRECTED RESULTS WERE REPORTED TO THE PHYSICIAN(S). THERE ARE NO KNOWN REPORTS OF PATIENT INTERVENTION OR ADVERSE HEALTH CONSEQUENCES DUE TO THE DISCORDANT DIGOXIN RESULTS.

N

Patient 1

A SIEMENS FIELD SERVICE ENGINEER WAS DISPATCHED TO THE CUSTOMER SITE. AFTER EVALUATION OF THE INSTRUMENT AND INSTRUMENT DATA, THE FSE DISCOVERED A LEAK IN REAGENT PROBE 2 AND THE DIP PUMP. THE FSE REPLACED THE 5 MM SEAL AND THE 1 MM SEAL TO ADDRESS THE LEAKS. THE SYSTEM WAS RECALIBRATED AND QC WAS RUN, ALL OF WHICH WERE WITHIN RANGE. PATIENT SAMPLES WERE RUN AND RESULTED AS EXPECTED. THE CAUSE OF THE DISCORDANT DIGOXIN RESULTS WAS DUE TO THE OUT-OF-RANGE QC. THE CAUSE OF THE QC BEING OUT-OF-RANGE IS UNKNOWN, AS QC CAME INTO RANGE AND PATIENT SAMPLES RESULTED AS EXPECTED ON THE SAME INSTRUMENT PRIOR TO THE SERVICE VISIT. THIS INSTRUMENT IS PERFORMING ACCORDING TO SPECIFICATIONS. NO FURTHER EVALUATION OF THE DEVICE IS REQUIRED.