ACS:180 SE *

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 2005-04-14 for ACS:180 SE * manufactured by Kmc Systems Inc..

Event Text Entries

[400827] In 05, bayer received a report of multiple discrepant results associated with digoxin, thcg, myoglobin, ckmb, troponin assays on the acs:180 se instrument. Investigation indicated that a lab technician performed some needed troubleshooting to clear a clog that was detected 2 days ago, as part of these activities the technician removed and replaced the sample aspirate probe tubing. The following day, the customer indicated that myoglobin results had been recovering lower than expected. In addition, the qc material was reported to be low or not recovering anything. Upon inspection the customer indicated that the smaple probe tubing had come off and there was water under the instrument. The following day bayer dispatched a field engineer to investigate, the field serivice engineer confirmed that the sample probe tubing had come off sometime after the technician's troubleshooting actions 2 days later. The tubing was appropriately reconnected and the system was tested, system was determined to tbe operational. Once the instrument was operational the laboratory issued a corrected report for the discrepant results. Although discrepant results were reported there in no evidence of patient interventions. Bayer's assessment of the event indicates that the customer maintenance documents available to troubleshoot the instrument are appropriate, the probe tubing connection design is robust and adequate warnings are in place to prevent this from reoccuring. In this particular case, the troubleshooting actions taken by the lab technician may have inappropriately reconnected or loosened the sample probe tubing which eventually came off causing the discrepant results. The qc material being under range gave indications that there was an issue with the instrument. Bayer instructions for use indicate that if the quality control materials do not fall within the bayer's expected valves or within the laboratory's expected values the operator should review the insructions for use to ensure the assay was performed according to the procedures recommended by bayer; verify that the materials are not expired; verify that required maintenance was performed and if necessary, rerun the quality control samples or contact bayer for more assistance. At this time bayer considers this to be an isolated event, and is reporting this under part 803 because were this event to reoccur there could be patient interventions that constitute a risk to health. For medical device reporting purposes this event is considered closed.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2432235-2005-00006
MDR Report Key593370
Report Source06
Date Received2005-04-14
Date of Report2005-03-15
Date of Event2005-03-14
Date Added to Maude2005-04-21
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 Location0
Manufacturer ContactANDRES HOLLE
Manufacturer Street511 BENEDIC TAVENUE
Manufacturer CityTARRYTOWN NY 10591
Manufacturer CountryUS
Manufacturer Postal10591
Manufacturer Phone9145243494
Manufacturer G1KMC SYSTEMS INC.
Manufacturer Street*
Manufacturer CityMERRIMACK NH *
Manufacturer CountryUS
Manufacturer Postal Code*
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameACS:180 SE
Generic NameIMMUNOASSAY SYSTEM
Product CodeLCI
Date Received2005-04-14
Model NumberACS:180 SE
Catalog Number*
Lot Number*
ID Number*
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key583215
ManufacturerKMC SYSTEMS INC.
Manufacturer Address* MERRIMACK NH * US
Baseline Brand NameACS:180 SE
Baseline Generic NameIMMUNOASSAY SYSTEM
Baseline Model NoACS:180 SE
Baseline Catalog No*
Baseline ID*


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2005-04-14

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