MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01,05 report with the FDA on 2004-06-08 for VITROS CHEMISTRY PRODUCTS CKMB SLIDES 8058232 manufactured by Ortho-clinical Diagnostics, Inc..
[17255865]
A customer reported observing falsely low ckmb results using a qc fluid. False low results might lead to inappropriate physician action. Ther was no report of pt harm as a result of this event.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1319809-2005-00118 |
| MDR Report Key | 592759 |
| Report Source | 01,05 |
| Date Received | 2004-06-08 |
| Date of Report | 2004-05-17 |
| Date of Event | 2004-05-17 |
| Date Mfgr Received | 2004-05-17 |
| Device Manufacturer Date | 2002-06-01 |
| Date Added to Maude | 2005-04-20 |
| 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 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 0 |
| Manufacturer Contact | TOM SMITH |
| Manufacturer Street | 100 INDOGO CREEK DR |
| Manufacturer City | ROCHESTER NY 146265101 |
| Manufacturer Country | US |
| Manufacturer Postal | 146265101 |
| Manufacturer Phone | 5854533735 |
| Manufacturer G1 | * |
| Manufacturer Street | * |
| Manufacturer City | * |
| Manufacturer Country | * |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | VITROS CHEMISTRY PRODUCTS CKMB SLIDES |
| Generic Name | IN VITRO DIAGNOSTIC |
| Product Code | JJT |
| Date Received | 2004-06-08 |
| Model Number | NA |
| Catalog Number | 8058232 |
| Lot Number | 4912-0130-5667 |
| ID Number | NA |
| Device Expiration Date | 2004-01-01 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Eval'ed by Mfgr | Y |
| Implant Flag | N |
| Date Removed | A |
| Device Sequence No | 1 |
| Device Event Key | 582613 |
| Manufacturer | ORTHO-CLINICAL DIAGNOSTICS, INC. |
| Manufacturer Address | 100 INDIGO CRREK DRIVE ROCHESTER NY 146265101 US |
| Baseline Brand Name | VITROS CHEMISTRY PRODUCTS CKMB SLIDES |
| Baseline Generic Name | IN VITRO DIAGNOSTIC |
| Baseline Model No | NA |
| Baseline Catalog No | 8058232 |
| Baseline ID | NA |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2004-06-08 |