ICUP 5-DRUG INT. CUP W/ADULT. STRIP DUA-157

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer,health professional report with the FDA on 2017-04-02 for ICUP 5-DRUG INT. CUP W/ADULT. STRIP DUA-157 manufactured by Alere San Diego, Inc..

Event Text Entries

[71501940] Investigation conclusion: the customer's observation was not replicated in-house with retention and return products. Retention and return devices were tested with in-house drug free donor urine and all devices showed negative results for thc and coc analytes at read time and met qc specifications. No false positive results were observed during in-house testing. Manufacturing batch record review did not uncover any abnormalities. Based on the information available, there is no indication of a product deficiency and no corrective action is required.
Patient Sequence No: 1, Text Type: N, H10


[71501941] The customer reported receiving one unconfirmed false positive thc result on one donor urine specimen and one unconfirmed false positive cocaine result on another donor urine specimen. The unconfirmed false positive results occurred on 2 devices out of 25 devices used. No confirmation testing was performed.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2027969-2017-00061
MDR Report Key6451982
Report SourceCONSUMER,HEALTH PROFESSIONAL
Date Received2017-04-02
Date of Report2017-03-03
Date Mfgr Received2017-03-03
Date Added to Maude2017-04-02
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 ContactYA-LING KING
Manufacturer Street9975 SUMMERS RIDGE ROAD
Manufacturer CitySAN DIEGO CA 92121
Manufacturer CountryUS
Manufacturer Postal92121
Manufacturer Phone8588052084
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameICUP 5-DRUG INT. CUP W/ADULT. STRIP
Generic NameENZYME IMMUNOASSAY, COCAINE AND COCAINE METABOLITES
Product CodeDIO
Date Received2017-04-02
Returned To Mfg2017-03-22
Model NumberDUA-157
Lot NumberDOA6050024
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerALERE SAN DIEGO, INC.
Manufacturer Address9975 SUMMERS RIDGE ROAD SAN DIEGO CA 92121 US 92121


Patients

Patient NumberTreatmentOutcomeDate
10 2017-04-02

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