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 2015-05-29 for IMMULITE 2000 30002 manufactured by Siemens Healthcare Diagnostics Inc..
[5894543]
The customer has obtained a false negative result on one patient sample for human chorionic gonadotropin (hcg) on an immulite 2000 instrument. The patient sample was then repeated on the same immulite 2000 instrument and the result was positive and in alignment with the clinical picture of the patient. It is unknown if the initial or the repeated result for hcg were reported to the physician(s). There are no known reports of patient intervention or adverse health consequences due to false negative hcg result.
Patient Sequence No: 1, Text Type: D, B5
[13285632]
A siemens headquarters support center (hsc) specialist evaluated the instrument files provided by the customer. Hsc did not find any specific errors on the instrument that could be related to the discordant false negative sample at that time it was being run on the instrument. The cause of the false negative hcg result is unknown. The instrument is performing according to specifications. No further evaluation of this device is required.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 2247117-2015-00029 |
| MDR Report Key | 4804332 |
| Report Source | 01,05,06 |
| Date Received | 2015-05-29 |
| Date of Report | 2015-05-05 |
| Date of Event | 2015-04-30 |
| Date Mfgr Received | 2015-05-05 |
| Date Added to Maude | 2015-06-25 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 0 |
| Manufacturer Contact | AARTI AZIZ |
| Manufacturer Street | 511 BENEDICT AVENUE |
| Manufacturer City | TARRYTOWN NY 10591 |
| Manufacturer Country | US |
| Manufacturer Postal | 10591 |
| Manufacturer Phone | 9145242683 |
| Manufacturer G1 | SIEMENS HEALTHCARE DIAGNOSTICS INC. |
| Manufacturer Street | 62 FLANDERS BARTLEY ROAD |
| Manufacturer City | FLANDERS NJ 07836 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 07836 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | IMMULITE 2000 |
| Generic Name | IMMULITE 2000 |
| Product Code | JJQ |
| Date Received | 2015-05-29 |
| Model Number | IMMULITE 2000 |
| Catalog Number | 30002 |
| Operator | OTHER HEALTH CARE PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | SIEMENS HEALTHCARE DIAGNOSTICS INC. |
| Manufacturer Address | 62 FLANDERS BARTLEY ROAD FLANDERS NJ 07836 US 07836 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2015-05-29 |