MAUDE MDR 592759

MDR report key
592759
Report number
1319809-2005-00118
Event key
0
Event type
3
Date of event
2004-05-17
Date received
2004-06-08
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
TOM SMITH
Address
100 INDOGO CREEK DR ROCHESTER NY 14626 US
Phone
585-585-5854
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1VITROS CHEMISTRY PRODUCTS CKMB SLIDESIN VITRO DIAGNOSTICORTHO-CLINICAL DIAGNOSTICS, INC.JJTNA80582324912-0130-5667NYY

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12004-06-080

Event Narratives#

D

Patient 1

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.