ORTHO HCV 3.0 TEST KIT 930750

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2002-12-20 for ORTHO HCV 3.0 TEST KIT 930750 manufactured by Ortho-clinical Diagnostics.

Event Text Entries

[285511] The customer reported that while using hcv test kit, a sample that reported as positive on other test, reported a negative result on the hcv test kit. No death or serious injury was associated with this incident.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2250051-2002-00705
MDR Report Key435040
Date Received2002-12-20
Date of Report2002-12-11
Date of Event2002-09-21
Date Facility Aware2002-12-02
Report Date2002-12-18
Date Reported to Mfgr2002-12-02
Date Added to Maude2003-01-02
Event Key0
Report Source CodeDistributor report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameORTHO HCV 3.0 TEST KIT
Generic NameELISA TEST KIT
Product CodeLQI
Date Received2002-12-20
Model NumberNA
Catalog Number930750
Lot NumberTXE348
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeNA
Implant FlagN
Date RemovedA
Device Sequence No1
Device Event Key423992
ManufacturerORTHO-CLINICAL DIAGNOSTICS
Manufacturer Address1001 US HWY 202 RARITAN NJ 088690606 US
Baseline Brand NameORTHO HCV VERSION 3.0 ELISA TEST SYSTEM
Baseline Generic NameDIAGNOSTIC TEST KIT FOR ANTI-HCV
Baseline Model NoNA
Baseline Catalog No930750
Baseline IDPOSITIVE CONTRO


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2002-12-20

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