VITROS CHEMISTY PRODUCTS AMON SLIDES 1726926

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2015-10-16 for VITROS CHEMISTY PRODUCTS AMON SLIDES 1726926 manufactured by Ortho-clinical Diagnostics.

Event Text Entries

[28909497] The investigation determined that a lower than expected vitros amon quality control result from a non-vitros control fluid using vitros amon micro slides was obtained on a vitros 5,1 fs chemistry system. The assignable cause of the event cannot be definitively determined. An unknown quality issue associated with vitros amon reagent or a vitros instrument issue cannot be entirely ruled out. In addition, as the qc shift observed on (b)(6) was consistent across all three biorad qc fluid levels, user error due to potential mishandling of the vitros reagent cart cannot be ruled out as a contributing factor to the event.
Patient Sequence No: 1, Text Type: N, H10


[28909498] The customer observed a lower than expected vitros amon quality control result from a non-vitros control fluid using vitros amon micro slides on a vitros 5,1 fs chemistry system. Level 3 result: 181. 73 umol/l vs. Expected 245. 0 umol/l. Biased results of the direction and magnitude observed may lead to inappropriate physician action. The customer stated that no vitros amon patient samples were processed during the time frame of the event. However, the investigation cannot conclude that patient sample results would not be affected if the event were to recur undetected. There was no allegation of patient harm as a result of this event. (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1319809-2015-00111
MDR Report Key5156188
Date Received2015-10-16
Date of Report2015-10-16
Date of Event2015-09-12
Date Mfgr Received2015-09-17
Device Manufacturer Date2015-04-23
Date Added to Maude2015-10-16
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationMEDICAL TECHNOLOGIST
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. JAMES A STEVENS
Manufacturer Street100 INDIGO CREEK DRIVE
Manufacturer CityROCHESTER NY 14626
Manufacturer CountryUS
Manufacturer Postal14626
Manufacturer Phone5854533000
Manufacturer G1ORTHO-CLINICAL DIAGNOSTICS
Manufacturer Street513 TECHNOLOGY BLVD.
Manufacturer CityROCHESTER NY 14652
Manufacturer CountryUS
Manufacturer Postal Code14652
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameVITROS CHEMISTY PRODUCTS AMON SLIDES
Generic NameIN-VITRO DIAGNOSTIC
Product CodeJID
Date Received2015-10-16
Catalog Number1726926
Lot Number1014-0239-3212
Device Expiration Date2016-10-01
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerORTHO-CLINICAL DIAGNOSTICS
Manufacturer Address100 INDIGO CREEK DRIVE ROCHESTER NY 14626 US 14626


Patients

Patient NumberTreatmentOutcomeDate
10 2015-10-16

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