MAUDE MDR 6377068

MDR report key
6377068
Report number
3002769706-2017-00042
Event key
0
Event type
3
Date received
2017-03-03
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MS. ELLEN WELTMER
Address
595 ANGLUM ROAD SAINT LOUIS MO 63042 US
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1VIDAS? CMV IGG ASSAYVIDAS? CMV IGG ASSAUBIOM?RIEUX SALFZ30204R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12017-03-030

Event Narratives#

D

Patient 1

A CUSTOMER IN (B)(6) NOTIFIED BIOM?RIEUX OF DISCREPANT RESULTS ASSOCIATED WITH VIDAS? CMV IGG (REFERENCE 30204) RELATED TO FALSE POSITIVE RESULTS. THE CUSTOMER REPORTED THE DILUTION FACTORS OF 1:429 WHICH ACCOUNTS FOR THE HIGH RESULTS. THERE IS NO INDICATION OR REPORT FROM THE LABORATORY OR PHYSICIAN THAT THE DISCREPANT RESULT LED TO AN ADVERSE EVENT RELATED TO A PATIENT'S STATE OF HEALTH. NO INCORRECT INFORMATION WAS REPORTED TO THE PHYSICIAN BECAUSE THE RESULTS WERE IDENTIFIED AS INCORRECT IMMEDIATELY. THE CUSTOMER REPORTED THERE WAS APPROXIMATELY HALF AN HOUR DELAY REPORTING RESULTS. AN INTERNAL BIOM?RIEUX INVESTIGATION WILL BE INITIATED.

N

Patient 1

AN INTERNAL BIOM?RIEUX INVESTIGATION CONCLUDED THE FOLLOWING: THE ANALYSIS OF THE BATCH HISTORY RECORDS SHOWED NO ANOMALY. THERE WAS NO CAPA, NOR NON CONFORMITY FOR A SIMILAR ISSUE IN RELATION TO THE CUSTOMER'S ANOMALY. THERE WAS NO OTHER COMPLAINT FOR THE SAME ISSUE ON THE BATCH VIDAS (B)(6) LOT 1005287390/170920-0. ON MARCH 09TH, THE PRODUCT QUALITY LABORATORY TESTED THREE INTERNAL SAMPLES ((B)(6)) ON THE RETAINED KIT VIDAS (B)(6) BATCH 1005287390/170920-0 ON VIDAS PC. (B)(6), (B)(6) SAMPLE, TARGET 3.1, THE RESULT WAS < 4 (B)(6). (B)(6), THE SAME (B)(6) SAMPLE TESTED PURE BUT WITH THE DILUTION (1/428) ENTERED IN THE VIDAS SOFTWARE. THE RESULT WAS (B)(6) (993 UA/ML). (B)(6), AN EQUIVOCAL SAMPLE, TARGET 4.18, THE RESULT FOUND: 4 UA/ML EQUIVOCAL.. (B)(6), A (B)(6) SAMPLE, TESTED PURE THE RESULT WAS 176 UA/ML. (B)(6): THE SAME (B)(6) SAMPLE TESTED PURE BUT WITH THE DILUTION (1/429) ENTERED IN THE VIDAS SOFTWARE, THE RESULT WAS (B)(6) (77626 UA/ML). (B)(6): THE SAME SAMPLE WAS TESTED WITH A MANUAL DILUTION, THE RESULT IS POSITIVE ( 232 UA/ML) CONSISTENT WITH THE SAMPLE TESTED PURE. THE PRODUCT QUALITY LABORATORY REPRODUCED THE CUSTOMER'S ANOMALY. THE CONCENTRATIONS ARE EXPRESSED IN AU/ML. SAMPLES WITH (B)(6) CONCENTRATIONS > 400 AU/ML SHOULD BE REASSAYED AFTER DILUTION BY 1/4 IN SALINE SOLUTION. IF THE DILUTION FACTOR HAS NOT BEEN ENTERED WHEN THE WORK LIST WAS CREATED (SEE USER'S MANUAL), MULTIPLY THE RESULT BY THE DILUTION FACTOR TO OBTAIN THE SAMPLE CONCENTRATION. FOR SEROLOGICAL MONITORING, TO OBTAIN AN ACCURATE SERUM TITER, DILUTE THE SAMPLES WITH CONCENTRATIONS > 150 AU/ML IN ORDER TO OBTAIN A RESULT RANGING BETWEEN 50-150 AU/ML. SINCE NO INTERNATIONAL STANDARD IS AVAILABLE FOR THE DETERMINATION OF (B)(6), THE VIDAS (B)(6) REAGENT IS CALIBRATED AGAINST COLLECTION SERA. THERE IS NO DRIFT LINKED TO THE REAGENT VIDAS (B)(6) LOT 1005287390/170920-0.