CONCISE MONO TEST 004551

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1993-05-18 for CONCISE MONO TEST 004551 manufactured by Hybritech, Inc..

Event Text Entries

[20436225] On 1/28/93, patient was administered a test screening for mono test. The purchase datawas 8/31/92, per attached invoice. The test was conducted within four months of the purchase dte. Patient showed a positive test result and was prescribed medication by doctor for treatment of mono. Patient's condition worsened and he subsequently sought medical treatment from another facility where he incurred further medical bills for $621. 50. Test result taken at this facility revealed patient did not have mono, but diagnosed as having acute pharyngitis. Patient returned to original facility for an explanation and was retested by the same lpn using the same consise mono test kit and showed a negative test result. The concise test kit had an expiration date on the outside box as being 12/93, however the vials expiration dates were 2/93invalid data - regarding single use labeling of device. Patient medical status prior to event: invalid data. There was not multiple patient involvement. Invalid data - on device service/maintenance. No data - regarding date last serviced. Service provided by: invalid data. Invalid data - service records availability. No imminent hazard to public health claimed. Invalid data - whether device used as labeled/intended. Invalid data - regarding evaluation by user after event. Method of evaluation: none or unknown. Results of evaluation: none or unknown. Conclusion: none or unknown. Certainty of device as cause of or contributor to event: invalid data. Corrective actions: none or unknown. Invalid data - on device destroyed/disposed of status.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number33642-1993-09001
MDR Report Key5609
Date Received1993-05-18
Date of Report1993-03-19
Date of Event1993-01-28
Report Date1993-03-19
Date Added to Maude1993-07-16
Event Key0
Report Source CodeDistributor report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Reporter OccupationUNKNOWN
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameCONCISE MONO TEST
Product CodeKTN
Date Received1993-05-18
Catalog Number004551
Device Expiration Date1993-12-01
OperatorOTHER HEALTH CARE PROFESSIONAL
Device Availability*
Device Age01-AUG-92
Implant FlagN
Device Sequence No1
Device Event Key5308
ManufacturerHYBRITECH, INC.


Patients

Patient NumberTreatmentOutcomeDate
101. Other 1993-05-18

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