MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,user faci report with the FDA on 2016-06-09 for IQ200 AUTOMATED URINALYSIS SYSTEM 700-3347 manufactured by Iris International.
[47202867]
The customer sent a disc containing instrument information and audit trail to bec, and it was received on 06/08/2016. Further information will be provided upon completion of data analysis. The cause of the event is currently unknown. Bec internal identifier for this report is (b)(6). The patient's date of birth was redacted by the customer; the patient's weight was not provided by the customer.
Patient Sequence No: 1, Text Type: N, H10
[47202868]
The customer reported they ran sample id # (b)(6) in rack 4, position 1 on a iq200 automated urinalysis system and it came up on the screen with correct demographics and correct id # ((b)(6)). However, when the customer selected accept on the screen, the instrument reportedly printed results with id # (b)(6) but with correct patient demographics and results. The id # (b)(6) had been run the day before on the same rack and same position. The customer checked manual orders and there were no manual orders that had been entered or failed to be cleared. The customer repeated analysis of sample id # (b)(6) using rack 5, position 1 and all information was reported and printed correctly. The misidentified patient results were not reported out of the laboratory and there was no change or effect to patient treatment in connection to the event.
Patient Sequence No: 1, Text Type: D, B5
[50751007]
A backup disk from the customer was returned to beckman coulter, which was analyzed by the applications team. The analysis revealed that a problem occurred when sample (b)(6) was originally run, causing the chemistry portion to be separated from the microscopy section. When this separation of result segments occurs, if all result segments are not either deleted or consolidated properly, it will lead to future problems. The objective evidence of an error with separation is the sequence number for the original result which was zero (0) and was revealed when the system backup was reviewed. This sequence number only occurs when the chemistry and microscopy are broken apart. Additionally, the record shows that the specimen id was changed by the operator at this time. Analysis was unable to determine why the sample analysis stamp date is different than the verification dates. The root cause is unknown and inconclusive.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 2023446-2016-00273 |
| MDR Report Key | 5710664 |
| Report Source | HEALTH PROFESSIONAL,USER FACI |
| Date Received | 2016-06-09 |
| Date of Report | 2016-05-17 |
| Date of Event | 2016-05-17 |
| Date Mfgr Received | 2016-07-15 |
| Device Manufacturer Date | 2015-05-28 |
| Date Added to Maude | 2016-06-09 |
| 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 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | GOPAL MOHANTY |
| Manufacturer Street | 9172 ETON AVENUE |
| Manufacturer City | CHATSWORTH, CA CA 91311 |
| Manufacturer Country | US |
| Manufacturer Postal | 91311 |
| Manufacturer Phone | 8185277379 |
| Manufacturer G1 | IRIS INTERNATIONAL |
| Manufacturer Street | 9172 ETON AVE |
| Manufacturer City | CHATSWORTH CA 91311 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 91311 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Removal Correction Number | NA |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | IQ200 AUTOMATED URINALYSIS SYSTEM |
| Generic Name | COUNTER, URINE PARTICLE |
| Product Code | LKM |
| Date Received | 2016-06-09 |
| Model Number | NA |
| Catalog Number | 700-3347 |
| Lot Number | NA |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | IRIS INTERNATIONAL |
| Manufacturer Address | 9172 ETON AVE CHATSWORTH CA 91311 US 91311 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2016-06-09 |