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 2004-02-18 for TESTPACK PLUS HCG 3C07-16 manufactured by Abbott Laboratories.
[367866]
A pt presented to the emergency center with symptoms of a cold in 2003 and it was determined that certain medications be prescribed for them. A urine sample was collected at that time and tested with the abbott testpack +plus hcg urine assay. The assay generated a negative result and the medication was administered. The pt subsequently miscarried in 2004.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1451914-2004-00002 |
| MDR Report Key | 512680 |
| Report Source | 01,05,06 |
| Date Received | 2004-02-18 |
| Date of Report | 2004-02-17 |
| Date of Event | 2004-01-27 |
| Date Mfgr Received | 2004-01-27 |
| Date Added to Maude | 2004-02-25 |
| 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 | DR DAVID SPINDELL |
| Manufacturer Street | 100 ABBOTT PARK ROAD |
| Manufacturer City | ABBOTT PARK IL 600646092 |
| Manufacturer Country | US |
| Manufacturer Postal | 600646092 |
| Manufacturer Phone | 8479351869 |
| Manufacturer G1 | * |
| Manufacturer Street | * |
| Manufacturer City | * |
| Manufacturer Country | * |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | TESTPACK PLUS HCG |
| Generic Name | RAPID PREGNANCY TEST |
| Product Code | JHJ |
| Date Received | 2004-02-18 |
| Model Number | NA |
| Catalog Number | 3C07-16 |
| Lot Number | UNK |
| ID Number | NA |
| Operator | UNKNOWN |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Implant Flag | N |
| Date Removed | A |
| Device Sequence No | 1 |
| Device Event Key | 501690 |
| Manufacturer | ABBOTT LABORATORIES |
| Manufacturer Address | INTERSECTION U.S. 41 & 22ND ST NORTH CHICAGO IL 60064 US |
| Baseline Brand Name | TESTPACK +PLUS HCG URINE |
| Baseline Generic Name | QUALITATIVE URINE PREGNANCY TEST |
| Baseline Model No | NA |
| Baseline Catalog No | 3C07-16 |
| Baseline ID | NA |
| Baseline Device Family | TESTPACK +2 URINE |
| Baseline Shelf Life Contained | Y |
| Baseline Shelf Life [Months] | 13 |
| Baseline PMA Flag | N |
| Baseline 510K PMN | Y |
| Premarket Notification | K954029 |
| Baseline Preamendment | N |
| Baseline Transitional | N |
| 510k Exempt | N |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2004-02-18 |