LDL_C LDL-CHOLESTEROL PLUS 3ND GENERATION 07005717190

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-08-31 for LDL_C LDL-CHOLESTEROL PLUS 3ND GENERATION 07005717190 manufactured by Roche Diagnostics.

Event Text Entries

[54410899] This event occurred in (b)(6).
Patient Sequence No: 1, Text Type: N, H10


[54410900] Since (b)(6) 2015, the customer received questionable hdlc3 hdl-cholesterol plus 3rd generation and ldl_c ldl-cholesterol plus 2nd generation results when compared to the results received for chol2 cholesterol gen. 2. The sum of the hdl and ldl results did not fit to the cholesterol result. In some cases, the results did not fit to the disease of the patient. Data was provided from two cobas c501 analyzers. The serial number for one analyzer was (b)(4). The serial number of the other analyzer was requested, but was not provided. This medwatch is for the ldl assay. Refer to the medwatch with (b)(6) for the hdl assay. The specific number of patient samples involved was unknown. Data was provided for 65 patient samples. Refer to the attachments to the medwatch for all patient data. The customer believed the results for cholesterol to be correct and the results for hdl and ldl to be incorrect. Information concerning if any erroneous result was reported outside the laboratory was requested, but it was unknown. There was no adverse event. Upon review of the patient data, it was assumed the root cause was abnormal liver function of the patients as many low hdl results and low ldl/chol results were noted with other liver parameters out of the normal range. Based on the provided analyzer data, the system performance of both c501 analyzers was acceptable. Therefore a general issue with systems was excluded.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1823260-2016-01292
MDR Report Key5919265
Date Received2016-08-31
Date of Report2016-08-31
Date of Event2015-10-01
Date Mfgr Received2016-08-10
Date Added to Maude2016-08-31
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactNA MICHAEL LESLIE
Manufacturer Street9115 HAGUE ROAD NA
Manufacturer CityINDIANAPOLIS IN 46250
Manufacturer CountryUS
Manufacturer Postal46250
Manufacturer Phone3175214343
Manufacturer G1ROCHE DIAGNOSTICS GMBH
Manufacturer StreetSANDHOFERSTRASSE 116 NA
Manufacturer CityMANNHEIM (BADEN-WURTTEMBERG) 68305
Manufacturer CountryGM
Manufacturer Postal Code68305
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report0

Device Details

Brand NameLDL_C LDL-CHOLESTEROL PLUS 3ND GENERATION
Generic NameSYSTEM, TEST, LOW DENSITY, LIPOPROTEIN
Product CodeLBR
Date Received2016-08-31
Model NumberNA
Catalog Number07005717190
Lot Number133901
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device Availability*
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerROCHE DIAGNOSTICS
Manufacturer Address9115 HAGUE ROAD NA INDIANAPOLIS IN 462500457 US 462500457


Patients

Patient NumberTreatmentOutcomeDate
10 2016-08-31

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