CRPL3 C-REACTIVE PROTEIN GEN.3 05172373190

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional,u report with the FDA on 2016-10-07 for CRPL3 C-REACTIVE PROTEIN GEN.3 05172373190 manufactured by Roche Diagnostics.

Event Text Entries

[56961663] (b)(4). This event occurred in (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[56961664] The customer received questionable crpl3 c-reactive protein gen. 3 results from two roche analyzers. Information was provided that one was cobas 8000 serial number (b)(4). The customer had recently started using this reagent lot and the qc was drifting to +3sd throughout the day. The customer recalibrates the assay and the qc comes back within the acceptable limits. The customer also saw an affect to patient sample results. Of the data provided for (b)(6) patient samples, one was discrepant. The first result was 122. 84 mg/l and a repeat result was 89. 46 mg/l after the reagent was recalibrated and qc performed. Information regarding if any erroneous result was reported outside the lab was requested but it was unknown. No patient was adversely affected. The customer previously had the exact same issue with crp around a year or so ago. In that instance the issue was resolved by using a new lot of reagent. Based on the data provided, the calibrations appeared acceptable and no differences were obvious. No drift was noted in the qc data except for qc with a concentration of 118 mg/l.
Patient Sequence No: 1, Text Type: D, B5


[60490683] The laboratory support coordinator checked the handling of the calibrators and reagents and installed a new lot of calibrator material on the analyzers. Since this visit, there have been no further issues so it appeared that either the mixing of the reagent or the new calibrator lot resolved the issue. A specific root cause could not be determined. Additional information for further investigation was requested but was not provided.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1823260-2016-01535
MDR Report Key6010610
Report SourceFOREIGN,HEALTH PROFESSIONAL,U
Date Received2016-10-07
Date of Report2016-11-14
Date of Event2016-09-16
Date Mfgr Received2016-09-16
Date Added to Maude2016-10-07
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 Report3

Device Details

Brand NameCRPL3 C-REACTIVE PROTEIN GEN.3
Generic NameC-REACTIVE PROTEIN IMMUNOLOGICAL TEST SYSTEM
Product CodeDCN
Date Received2016-10-07
Model NumberNA
Catalog Number05172373190
Lot Number157142
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
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 2016-10-07

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