DADE ACTIN FSL ACTIVATED PTT REAGENT B4219-2

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2014-04-29 for DADE ACTIN FSL ACTIVATED PTT REAGENT B4219-2 manufactured by Siemens Healthcare Diagnostics Products Gmbh.

Event Text Entries

[21719176] Discrepant elevated activated partial thromboplastin time (aptt) results were obtained on qc and patient samples. Patient results were reported to the physician during an interval of incorrect aptt protocol settings. The qc samples were repeated with the correct protocol settings and lower, within range results were obtained. It is unknown if patient treatment was altered or prescribed due to discrepant aptt results reported. There is no report of adverse outcome to the patients as a result of the discrepant aptt results.
Patient Sequence No: 1, Text Type: D, B5


[22007712] The cause of the discrepant elevated activated partial thromoboplastin time results is user error. The account entered the incorrect u. S. Settings calibration curve input for the activated partial thromboplastin time (aptt) with actin fsl using lot 547378. These values are manually input by the operator. The incorrect curve has been in use since mid-february. The issue was resolved by directing the account to use a u. S. Settings calibration curve with the appropriate input for the aptt with actin fsl. The instrument is performing within specifications. No further evaluation of the device is required.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number9610806-2014-00018
MDR Report Key3777273
Report Source05,06
Date Received2014-04-29
Date of Report2014-04-01
Date of Event2014-03-17
Date Mfgr Received2014-04-01
Device Manufacturer Date2013-05-08
Date Added to Maude2014-06-19
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationMEDICAL TECHNOLOGIST
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactJAMES MORGERA
Manufacturer StreetGLASGOW BUSINESS COMMUNITY PO BOX 6101
Manufacturer CityNEWARK DE 197146101
Manufacturer CountryUS
Manufacturer Postal197146101
Manufacturer Phone3026318356
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS PRODUCTS GMBH
Manufacturer Street76 EMIL VON BEHRING STRASSE
Manufacturer CityMARBURG, 35041
Manufacturer CountryGM
Manufacturer Postal Code35041
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameDADE ACTIN FSL ACTIVATED PTT REAGENT
Generic NameDADE ACTIN FSL ACTIVATED PTT REAGENT
Product CodeGGW
Date Received2014-04-29
Catalog NumberB4219-2
Lot Number547378
Device Expiration Date2015-04-01
OperatorMEDICAL TECHNOLOGIST
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS PRODUCTS GMBH
Manufacturer Address76 EMIL VON BEHRING STRASSE MARBURG, 35041 GM 35041


Patients

Patient NumberTreatmentOutcomeDate
10 2014-04-29

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