A HIGH RES SSP UNITRAY W/TAQ10 4729110

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 2015-07-10 for A HIGH RES SSP UNITRAY W/TAQ10 4729110 manufactured by Life Technologies.

Event Text Entries

[6030538] This report is related to customer complaint (b)(4) made against allset gold a high res ssp (sku 54010d, lot 012 1608823), since this lot contains the same affected primer mix. The customer reported that the reactivity for lane 86 was negative for the a 03:20 alele when the labeling indicates the reactivity should be positive. The labeling discrepancy may lead to potentially mistyping a a 03:20 allele as an a 03:01 allele.
Patient Sequence No: 1, Text Type: D, B5


[14207413] The investigation replicated the customer's observation 06/09/2015. The investigation concluded on 06/16/2015 and was unable to determine whether the result is related to the specific dna sample or reflective or incorrect labeling on the reactivity for the allele.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2244574-2015-00089
MDR Report Key4912879
Report Source05
Date Received2015-07-10
Date of Report2015-05-22
Date of Event2015-05-22
Device Manufacturer Date2015-02-13
Date Added to Maude2015-07-23
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 ContactTHOMAS TYRE
Manufacturer Street9099 NORTH DEERBROOK TRAIL
Manufacturer CityBROWN DEER WI 53223
Manufacturer CountryUS
Manufacturer Postal53223
Manufacturer Phone4142144025
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameA HIGH RES SSP UNITRAY W/TAQ10
Generic NameTEST, QUALITATIVE FOR HLA
Product CodeMZI
Date Received2015-07-10
Catalog Number4729110
Lot Number012 1608873 1687240
Device Expiration Date2016-01-31
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerLIFE TECHNOLOGIES
Manufacturer AddressBROWN DEER WI US


Patients

Patient NumberTreatmentOutcomeDate
10 2015-07-10

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