DIMENSION VISTA 1500

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,user faci report with the FDA on 2016-11-21 for DIMENSION VISTA 1500 manufactured by Siemens Healthcare Diagnostics Inc.

Event Text Entries

[60659080] The customer contacted the siemens customer care center (ccc). Ccc remotely dialed into the instrument and reviewed the instrument data. Ccc discovered that on october 27th, 2016, the prolactin method was calibrated by the customer, and the calibration failed. The customer manually accepted the failed calibration, and quality controls (qc) and patient samples which were subsequently run, resulted out of range. The error log indicated that there were several "aliquot module" and "reagent preparation probe- no cleaner" errors around the time of the failed calibration. A siemens customer service engineer (cse) was dispatched to the customer site for the errors observed. After evaluation of the instrument, the cse tightened the fittings, performed a total service visit and ran qc and a system check, all of which passed. Following the service visit, the customer successfully recalibrated the method, and reran qc, which resulted within range. Patient samples were then repeated, resulting as expected. The cause of the discordant, falsely elevated prolactin results was due to the customer running samples with a failed calibration. This is a user error. The instrument is performing according to specifications. No further evaluation of the device is required.
Patient Sequence No: 1, Text Type: N, H10


[60659081] Discordant, falsely elevated prolactin results were obtained on patient samples on a dimension vista 1500 instrument. The discordant results of four patient samples were reported to a physician(s), who called the customer and questioned two patient sample results. The discordant results of the remaining patients were not reported out, and the samples were automatically rerun on an alternate dimension vista instrument and the repeat results were reported out. The customer performed troubleshooting and repeated the samples of the four patients that were initially reported. The corrected results were reported out to the physician(s). There are no reports of patient intervention or adverse health consequences due to the discordant, falsely elevated prolactin results.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2517506-2016-00457
MDR Report Key6117987
Report SourceHEALTH PROFESSIONAL,USER FACI
Date Received2016-11-21
Date of Report2016-11-21
Date of Event2016-10-27
Date Mfgr Received2016-10-31
Device Manufacturer Date2016-04-20
Date Added to Maude2016-11-21
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMARGARITA KARAN
Manufacturer Street511 BENEDICT AVE
Manufacturer CityTARRYTOWN NY 10591
Manufacturer CountryUS
Manufacturer Postal10591
Manufacturer Phone9145243105
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS INC
Manufacturer StreetREGISTRATION NUMBER: 1226181 101 SILVERMINE ROAD
Manufacturer CityBROOKFIELD CT 06804
Manufacturer CountryUS
Manufacturer Postal Code06804
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Sequence Number: 0

Brand NameDIMENSION VISTA 1500
Generic NameCLINICAL CHEMISTRY ANALYZER
Product CodeCFT
Date Received2016-11-21
Model NumberDIMENSION VISTA 1500
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No0
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS INC
Manufacturer Address500 GBC DRIVE PO BOX 6101 NEWARK DE 197146101 US 197146101

Device Sequence Number: 1

Brand NameDIMENSION VISTA 1500
Generic NameCLINICAL CHEMISTRY ANALYZER
Product CodeJJE
Date Received2016-11-21
Model NumberDIMENSION VISTA 1500
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS INC
Manufacturer Address500 GBC DRIVE PO BOX 6101 NEWARK DE 197146101 US 197146101


Patients

Patient NumberTreatmentOutcomeDate
10 2016-11-21

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