MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2014-03-21 for ADVIA CENTAUR XP 078-A011-03 manufactured by Siemens Healthcare Diagnostics Inc..
[4255518]
Discordant cancer antigen 15. 3 (ca-15. 3), free thyroxine 4 (ft4) and vitamin d (vit d) results were obtained on patient samples on an advia centaur xp instrument. The discordant results were reported to the physician(s), who questioned them. The samples were repeated on the same instrument, resulting higher. The corrected results were reported to the physician(s). There are no reports of patient intervention or adverse health consequences due to the discordant ca-15. 3, ft4 and vit d results.
Patient Sequence No: 1, Text Type: D, B5
[11590050]
A siemens customer service engineer (cse) was at the customer site. After evaluation of the instrument and instrument data, the cse addressed a leak noted by the customer. The cse replaced valves 66, 67, 76 and 77 and the pressure transducer. The cause of the discordant, falsely low ca-15. 3, ft4 and vit d results are faulty valves and the pressure transducer. The instrument is performing according to specifications. No further evaluation of the device is required.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 2432235-2014-00240 |
| MDR Report Key | 3693555 |
| Report Source | 05,06 |
| Date Received | 2014-03-21 |
| Date of Report | 2014-02-26 |
| Date of Event | 2014-02-25 |
| Date Mfgr Received | 2014-02-26 |
| Device Manufacturer Date | 2010-07-19 |
| Date Added to Maude | 2014-05-21 |
| 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 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | CASSANDRA KOCSIS |
| Manufacturer Street | 511 BENEDICT AVENUE |
| Manufacturer City | TARRYTOWN 10591 |
| Manufacturer Country | US |
| Manufacturer Postal | 10591 |
| Manufacturer Phone | 9145242687 |
| Manufacturer G1 | SIEMENS HEALTHCARE DIAGNOSTICS |
| Manufacturer Street | MANUFACTURING LIMITED REGISTRATION NUMBER: 8020888 |
| Manufacturer City | CHAPEL LANE, SWORDS, CO., DUBLIN |
| Manufacturer Country | EI |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ADVIA CENTAUR XP |
| Generic Name | CLINICAL CHEMISTRY ANALYZER |
| Product Code | KLI |
| Date Received | 2014-03-21 |
| Model Number | ADVIA CENTAUR XP |
| Catalog Number | 078-A011-03 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | SIEMENS HEALTHCARE DIAGNOSTICS INC. |
| Manufacturer Address | 511 BENEDICT AVENUE TARRYTOWN NY 10591 US 10591 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2014-03-21 |