VITROS CHEMISTRY PRODUCTS AMPH REAGENT 6801991

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-02-23 for VITROS CHEMISTRY PRODUCTS AMPH REAGENT 6801991 manufactured by Ortho-clinical Diagnostics.

Event Text Entries

[39311477] The investigation determined that a lower than expected vitros amph proficiency result occurred on a vitros 4600 chemistry system. The investigation concludes that a false negative vitros amph result was obtained from a proficiency sample based on an unknown amphetamine compound present in the sample with a value of 1500 ng/ml. The root cause is a known limitation of the vitros amph reagent. The unknown amphetamine compound most likely has a low cross reactivity with the vitros amph reagent as stated in the vitros amph instructions for use (ifu). The vitros 4600 system did not malfunction.
Patient Sequence No: 1, Text Type: N, H10


[39311478] A customer observed a lower than expected vitros amph result from a proficiency sample fluid processed on a vitros 4600 chemistry system. Vitros amph proficiency sample result: 979 ng/ml (negative) versus expected result of 1500 ng/ml (positive) using a cutoff of 1000 ng/ml. The customer made no allegations that patient sample results were affected. However, biased patient results of the direction and magnitude observed may lead to inappropriate physician action if occurred 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 Number1319808-2016-00001
MDR Report Key5453422
Date Received2016-02-23
Date of Report2016-02-23
Date of Event2015-11-10
Date Mfgr Received2016-01-27
Device Manufacturer Date2015-03-01
Date Added to Maude2016-02-23
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 Street1000 LEE ROAD
Manufacturer CityROCHESTER NY 14606
Manufacturer CountryUS
Manufacturer Postal Code14606
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameVITROS CHEMISTRY PRODUCTS AMPH REAGENT
Generic NameIN VITRO DIAGNOSTIC
Product CodeDKZ
Date Received2016-02-23
Catalog Number6801991
Lot Number1521-04-4408
Device Expiration Date2016-03-01
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 2016-02-23

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