MAUDE MDR 4866822

MDR report key
4866822
Report number
3002809144-2015-00043
Event key
0
Event type
3
Date of event
2015-05-07
Date received
2015-06-24
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
NOEMI ROMERO-KONDOS, RN BSN
Address
100 ABBOTT PARK ROAD DEPT. 09B9, LCCP1-3 ABBOTT PARK IL 60064 US
Phone
224-224-2246
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1ARCHITECT HE4HE4ABBOTT GERMANYOIU02P54-2542042M500Y N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12015-06-240

Event Narratives#

D

Patient 1

THE CUSTOMER STATED THAT A FALSELY DECREASED ARCHITECT HE4 RESULT OF 33.2 PMOL/L WAS GENERATED FOR A PATIENT WITH A CA 125 RESULT OF 433.1 U/ML AND 3.6% ROMA (RISK OF OVARIAN MALIGNANCY ALGORITHM) ON (B)(6) 2015. THIS TESTING WAS PERFORMED BECAUSE A PELVIC MASS WAS FOUND IN THE PATIENT'S SONOGRAPHY REPORT. SURGERY WAS PERFORMED ON (B)(6) 2015 AND THE HISTOPATHOLOGICAL DIAGNOSIS REVEALED SERIOUS CARCINOMA OF THE OVARY. THE POST-SURGICAL ROMA WAS 49.8%. A POST-SURGICAL HE4 RESULT WAS NOT PROVIDED. NO ADVERSE IMPACT TO PATIENT MANAGEMENT WAS REPORTED.

N

Patient 1

AN EVALUATION IS IN PROCESS. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN THE EVALUATION IS COMPLETE. (B)(4).

N

Patient 1

THIS FOLLOW-UP EMDR IS BEING SUBMITTED TO CORRECT THE PRODUCT CODE. SUSPECT MEDICAL DEVICE. THE CORRECT PRODUCT CODE FOR THIS MEDICAL DEVICE, ARCHITECT (B)(4). AN EVALUATION IS IN PROCESS. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN THE DEVICE EVALUATION IS COMPLETE.

N

Patient 1

REVIEW OF TICKET TRENDING AND LOT SEARCH DATA DID NOT IDENTIFY AN INCREASE IN COMPLAINT ACTIVITY RELATED TO DISCREPANT PATIENT RESULTS. ACCURACY TESTING WAS COMPLETED USING RETAINED KITS OF REAGENT LOT 42042M500. ACCEPTANCE CRITERIA WAS MET, WHICH INDICATES ACCEPTABLE PRODUCT PERFORMANCE. A DEFICIENCY WAS NOT IDENTIFIED AS ACCURACY TESTING SHOWS THAT THE ASSAY PERFORMS PER SPECIFICATION. NO MALFUNCTION WAS IDENTIFIED SINCE THE ISSUE INVOLVES ONE DISCREET PATIENT AND THE SENSITIVITY FOR STRATIFYING PATIENTS WITH STAGE I-IV EPITHELIAL OVARIAN CANCER INTO THE HIGH RISK GROUP IS 93% AT A SPECIFICITY OF 75%. ADDITIONALLY, THE LIMITATIONS OF THE PROCEDURE AND EXPECTED VALUES SECTION OF THE ARCHITECT HE4 PACKAGE INSERT ADDRESSES THE CUSTOMER'S ISSUE.