SIMPLEXA FLU A/B AND RSV DIRECT ASSAY MOL2650

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2014-12-29 for SIMPLEXA FLU A/B AND RSV DIRECT ASSAY MOL2650 manufactured by Focus Diagnostics, Inc..

Event Text Entries

[19373976] The investigation of the simplexa flu a/b rsv direct kit (mol2650) suggested that the root cause for the occurrence of false positive (and sub-amplifications) were due to the lot to lot variability of the scorpion primers. To mitigate the occurrence of false positives (and sub-amplifications), (b)(4). These corrective and preventative actions are effective in mitigating the effects posed by the potential lot to lot variability of the scorpions. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[19401064] The customer reported low level rsv values on pt samples. The rsv did cross the threshold and the software indicated "detected". The laboratory did not report the rsv positive results. A voluntary recall has been performed related to the reported lot.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2023365-2014-00009
MDR Report Key4379605
Report Source05
Date Received2014-12-29
Date of Report2014-01-10
Date of Event2014-01-09
Date Mfgr Received2014-01-08
Device Manufacturer Date2013-12-01
Date Added to Maude2015-01-14
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactVALERIE CIMMARUSTI, CLS
Manufacturer Street11331 VALLEY VIEW ST
Manufacturer CityCYPRESS CA 90630
Manufacturer CountryUS
Manufacturer Postal90630
Manufacturer Phone5622406484
Single Use3
Remedial ActionRC
Previous Use Code3
Removal Correction NumberZ-0846-2014
Event Type3
Type of Report3

Device Details

Brand NameSIMPLEXA FLU A/B AND RSV DIRECT ASSAY
Generic NameIN-VITRO-DIAGNOTIC TEST, INFLUENZA
Product CodeOCC
Date Received2014-12-29
Model NumberMOL2650
Catalog NumberMOL2650
Lot Number24535
ID NumberNA
Device Expiration Date2014-12-31
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerFOCUS DIAGNOSTICS, INC.
Manufacturer AddressCYPRESS CA US


Patients

Patient NumberTreatmentOutcomeDate
10 2014-12-29

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