ADVIA CENTAUR 078-A001-08

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 2014-10-29 for ADVIA CENTAUR 078-A001-08 manufactured by Siemens Healthcare Diagnostics, Inc..

Event Text Entries

[5043333] (b)(6) results were obtained on multiple patient samples on an advia centaur instrument. The initial results were not reported to the physician(s). The samples were repeated on the same system. It is unknown as to which repeat (b)(6) results were reported to the physician(s). There are no known reports of adverse health consequences or patient intervention due to the discordant (b)(6) results.
Patient Sequence No: 1, Text Type: D, B5


[12448139] A siemens customer service engineer (cse) was dispatched to the customer site. After evaluation of the instrument and instrument data, the cse replaced the dispense diluter 1 assembly. The cse also performed an instrument service check. The cause of the discordant (b)(6) results is unknown. The cse successfully ran a dispense test and quality controls. 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 Number2432235-2014-00625
MDR Report Key4212192
Report Source05,06
Date Received2014-10-29
Date of Report2014-10-04
Date of Event2014-10-04
Date Mfgr Received2014-10-04
Device Manufacturer Date2005-09-29
Date Added to Maude2014-11-12
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional0
Initial Report to FDA3
Report to FDA3
Event Location0
Manufacturer ContactJOHN NELSON
Manufacturer Street511 BENEDICT AVENUE
Manufacturer CityTARRYTOWN NY 10591
Manufacturer CountryUS
Manufacturer Postal10591
Manufacturer Phone9145242530
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS
Manufacturer StreetMANUFACTURING LIMITED REGISTRATION NUMBER: 8020888
Manufacturer CityCHAPEL LANE, SWORDS CO DUBLIN
Manufacturer CountryEI
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameADVIA CENTAUR
Generic NameIMMUNOASSAY ANALYZER
Product CodeNHS
Date Received2014-10-29
Model NumberADVIA CENTAUR
Catalog Number078-A001-08
ID NumberN/A
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 2014-10-29

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