ADVIA CENTAUR 078-A001-13

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 2014-10-03 for ADVIA CENTAUR 078-A001-13 manufactured by Siemens Healthcare Diagnostics Inc..

Event Text Entries

[4947910] A discordant, (b)(6) result was obtained on one patient sample on an advia centaur instrument. The discordant result was not reported to the physician(s). The sample was repeated twice on the same instrument, resulting (b)(6) for (b)(6). It is unknown if the corrected result was reported to the physician(s). There are no reports of patient intervention or adverse health consequences due to the discordant, (b)(6) result.
Patient Sequence No: 1, Text Type: D, B5


[12245654] A siemens customer service engineer (cse) was dispatched to customer site. After evaluation of the instrument and instrument data, the cse found the sample dispense was slightly misaligned and adjusted it from 769 to 771. The cse also replaced the acid pump tubing connector due to a leak. The cause of the discordant, (b)(6) result is unknown. The instrument is performing according to specifications. No further evaluation of the device is required.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2432235-2014-00581
MDR Report Key4140996
Report Source01,05,06
Date Received2014-10-03
Date of Report2014-09-12
Date of Event2014-09-08
Date Mfgr Received2014-09-12
Device Manufacturer Date2006-06-19
Date Added to Maude2014-10-16
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 ContactCASSANDRA KOCSIS
Manufacturer Street511 BENEDICT AVENUE
Manufacturer CityTARRYTOWN 10591
Manufacturer CountryUS
Manufacturer Postal10591
Manufacturer Phone9145242687
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS
Manufacturer StreetREGISTRATION NUMBER: 8020888 MANUFACTURING LIMITED
Manufacturer CityCHAPEL LANE, DUBLIN, SWORDS, CO.
Manufacturer CountryEI
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameADVIA CENTAUR
Generic NameCLINICAL CHEMISTRY ANALYZER
Product CodeOBF
Date Received2014-10-03
Model NumberADVIA CENTAUR
Catalog Number078-A001-13
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS INC.
Manufacturer Address511 BENEDICT AVENUE TARRYTOWN NY 10591 US 10591


Patients

Patient NumberTreatmentOutcomeDate
10 2014-10-03

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