VITROS CHEMISTRY PRODUCTS CKMB SLIDES 8001133

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 00,01,05 report with the FDA on 2014-12-08 for VITROS CHEMISTRY PRODUCTS CKMB SLIDES 8001133 manufactured by Ortho-clinical Diagnostics.

Event Text Entries

[5193097] The customer reported lower than expected vitros ckmb quality control results were obtained on a vitros 250 chemistry system. Vitros ckmb results 10. 6, 10. 9, 11. 0, 10. 6, 11. 8, 10. 4, 10. 1, 6. 1, 9. 7 versus 18. 1 u/l. A biased result of the direction and magnitude observed may lead to inappropriate physician action if undetected. No patient samples were affected, and there was no allegation of patient harm as a result of this event. This report corresponds to ortho clinical diagnostics inc. Complaint numbers (b)(4).
Patient Sequence No: 1, Text Type: D, B5


[12508591] The investigation determined that lower than expected vitros ckmb quality control results were obtained on a vitros 250 chemistry system. The investigation concludes that the most likely cause of this event is user error due to improper vitros ckmb microslide reagent handling. The investigation determined that the vitros ckmb reagent storage conditions were not according to the recommended vitros instructions for use. Acceptable performance was obtained following replacement of the affected vitros ckmb slides with a different lot of vitros ckmb slides at the customer site. There was no indication of a systemic quality issue associated with vitros ckmb slide lot 4933-0195-3983.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1319809-2014-00068
MDR Report Key4305923
Report Source00,01,05
Date Received2014-12-08
Date of Report2014-12-08
Date of Event2014-11-22
Date Mfgr Received2014-11-10
Device Manufacturer Date2014-05-21
Date Added to Maude2014-12-15
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 ContactMR. JAMES A STEVENS
Manufacturer Street100 INDIGO CREEK DRIVE
Manufacturer CityROCHESTER NY 14626
Manufacturer CountryUS
Manufacturer Postal14626
Manufacturer Phone5854533000
Manufacturer G1ORTHO-CLINICAL DIAGNOSTICS
Manufacturer Street513 TECHNOLOGY BLVD.
Manufacturer CityROCHESTER NY 14652
Manufacturer CountryUS
Manufacturer Postal Code14652
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameVITROS CHEMISTRY PRODUCTS CKMB SLIDES
Generic NameIN-VITRO DIAGNOSTIC
Product CodeJHS
Date Received2014-12-08
Catalog Number8001133
Lot Number4933-0195-3983
Device Expiration Date2015-11-01
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerORTHO-CLINICAL DIAGNOSTICS
Manufacturer Address100 INDIGO CREEK DRIVE ROCHESTER NY 14626 US 14626


Patients

Patient NumberTreatmentOutcomeDate
10 2014-12-08

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