VITROS SALI SLIDES 800 1083

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 1996-08-30 for VITROS SALI SLIDES 800 1083 manufactured by Johnson &johnson Clinical Diagnostics.

Event Text Entries

[23986] Pt sample mesured a salicylate of <1mg/dl (negative) using co salicylate slides. Result reported to physician. Physician requested a repeat of the test. A fresh pt sample was drawn and measured using the same cartridge of slides. Result was 3. 0 mg/dl (therapeutic range). A new cartridge was loaded and calibrated on instrument. Original sample and re-draw were run using new cartridge. Original sample gave 52mg/dl and re-draw gave 47 mg/dl. Both results are in the toxic range for salicylate. Physician stated that there were no adverse effects due to the misreported results.
Patient Sequence No: 1, Text Type: D, B5


[7773444] A total of 15 slide cartridges (270 slides) were returned to co for evaluation. The slides were tested using a quality control fluid, lot number g1272. All 270 slides tested gave results between 12. 5 to 13. 2 mg/dl. All slides tested were within the expected quality control range. Product performed within specifications. Alleged failure could not be duplicated.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1319809-1996-00001
MDR Report Key38954
Report Source05,06
Date Received1996-08-30
Date of Report1996-08-06
Date of Event1996-08-06
Date Mfgr Received1996-08-06
Device Manufacturer Date1996-02-01
Date Added to Maude1996-09-23
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Reporter OccupationMEDICAL TECHNOLOGIST
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameVITROS SALI SLIDES
Generic NameIN VITRO DIAGNOSTIC
Product CodeDKJ
Date Received1996-08-30
Model NumberNA
Catalog Number800 1083
Lot Number2206-0009-4400
ID NumberNA
Device Expiration Date1997-04-01
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Age*
Device Eval'ed by MfgrY
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key40185
ManufacturerJOHNSON &JOHNSON CLINICAL DIAGNOSTICS
Manufacturer Address100 INDIGO CREEK DR ROCHESTER NY 14650 US
Baseline Brand NameVITROS SALI SLIDES
Baseline Generic NameIN VITRO DIAGNOSTIC (SALICYLATE)
Baseline Model NoNA
Baseline Catalog No800 1083
Baseline IDNA
Baseline Device FamilyVITROS SALI SLIDES
Baseline Shelf Life ContainedY
Baseline Shelf Life [Months]14
Baseline PMA FlagN
Baseline 510K PMNY
Premarket NotificationK902356
Baseline PreamendmentN
Baseline TransitionalN
510k ExemptN


Patients

Patient NumberTreatmentOutcomeDate
10 1996-08-30

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