SYNERGIES PLUS NEGATIVE COMBO 3 B1016-201

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2013-09-11 for SYNERGIES PLUS NEGATIVE COMBO 3 B1016-201 manufactured by Siemens Healthcare Diagnostics, Inc..

Event Text Entries

[3745827] Testing by siemens with (b)(4) survey isolate d-12, k. Pneumoniae using synergies plus negative combo 3, lot 2013-02-01 provided discrepant results with imipenem when compared to a frozen reference method panel and microscan conventional overnight panels. Synergies plus negative combo 3: <4 mcg/ml, instrument 8 mcg/ml, frozen reference panel: 32 mcg/ml, 16 mcg/ml, and microscan conventional overnight panel: >8 mcg/ml. Siemens microscan conducted a field correction, internal number (b)(4) (fda number has not been assigned) on (b)(4) 2013 for false susceptible imipenem and meropenem with synergies plus negative panels. The customer letter stated that due to false susceptible results with imipenem and meropenem results should not be reported for susceptible or intermediate imipenem or meropenem on microscan synergies plus gram negative panels. As part of the field action, complaints were reviewed and it was determined a mdr was needed for this customer complaint.
Patient Sequence No: 1, Text Type: D, B5


[11168308] Method - compared internal testing to survey results. Results - results received on the microscan product did not agree with survey results. Conclusion - results received on the microscan product did not agree with survey results.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2919016-2013-00009
MDR Report Key3368333
Report Source05
Date Received2013-09-11
Date of Report2012-06-18
Date of Event2012-06-16
Date Mfgr Received2012-06-18
Device Manufacturer Date2012-02-01
Date Added to Maude2013-12-17
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactLESLIE ARDIZONE
Manufacturer Street2040 ENTERPRISE BLVD.
Manufacturer CityWEST SACRAMENTO CA 95691
Manufacturer CountryUS
Manufacturer Postal95691
Manufacturer Phone9163743075
Single Use3
Remedial ActionRC
Previous Use Code3
Removal Correction NumberMSSW 13-02 (FDA # NOT
Event Type3
Type of Report3

Device Details

Brand NameSYNERGIES PLUS NEGATIVE COMBO 3
Generic NameSYNERGIES PLUS NEGATIVE COMBO 3
Product CodeLTT
Date Received2013-09-11
Catalog NumberB1016-201
Lot Number2013-02-01
ID NumberNA
Device Expiration Date2013-02-01
OperatorOTHER
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS, INC.
Manufacturer Address2040 ENTERPRISE BLVD. WEST SACRAMENTO CA 95691 US 95691


Patients

Patient NumberTreatmentOutcomeDate
10 2013-09-11

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