DIMENSION VISTA 1500

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01,05,06 report with the FDA on 2014-03-03 for DIMENSION VISTA 1500 manufactured by Siemens Healthcare Diagnostics Inc.

Event Text Entries

[19021177] A discordant, falsely elevated potassium (k) result was obtained on a dimension vista 1500 instrument for one patient. The discordant result was reported to the physician. The potassium sample was not reanalyzed as the sample was hemolyzed. The customer did not provide a result for the patient with a new sample without hemolyze. There are no known reports of patient intervention or adverse health consequences due to the discordant k result.
Patient Sequence No: 1, Text Type: D, B5


[19128993] A siemens technical service consultant (tsc) was contacted by the customer. The tsc evaluated the instrument data and determined that the cause of the discordant potassium result was due to user error. The operator did not wait for the hemolysis, icterus, and lipemia index (hil) report before releasing the potassium result. The tsc instructed the customer on proper sample handling, specifically that the hil index is an indicator of sample quality for common interferences. The instrument is performing within specifications. Further evaluation of the device is not required.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1226181-2014-00109
MDR Report Key3654256
Report Source01,05,06
Date Received2014-03-03
Date of Report2014-02-05
Date of Event2014-01-31
Date Mfgr Received2014-02-05
Device Manufacturer Date2013-01-30
Date Added to Maude2014-05-12
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactJOHN NELSON
Manufacturer StreetSIEMENS HEALTHCARE DIAGNOSTICS 511 BENEDICT AVENUE
Manufacturer CityTARRYTOWN NY 10591
Manufacturer CountryUS
Manufacturer Postal10591
Manufacturer Phone9145242530
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS INC
Manufacturer Street101 SILVERMINE ROAD
Manufacturer CityBROOKFIELD CT 06804
Manufacturer CountryUS
Manufacturer Postal Code06804
Single Use0
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameDIMENSION VISTA 1500
Generic NameCHEMISTRY ANALYZER
Product CodeMZV
Date Received2014-03-03
Model NumberDIMENSION VISTA 1500
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Age1 YR
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS INC
Manufacturer Address101 SILVERMINE ROAD BROOKFIELD CT 06804 US 06804


Patients

Patient NumberTreatmentOutcomeDate
10 2014-03-03

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