MAUDE MDR 6509463

MDR report key
6509463
Report number
2027969-2017-00076
Event key
0
Event type
3
Date received
2017-04-20
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
YA-LING KING
Address
9975 SUMMERS RIDGE ROAD SAN DIEGO CA 92121 US
Phone
858-858-8588
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1MULTIDIP 8 DRUG KIT 25/PKENZYME IMMUNOASSAY, COCAINE AND COCAINE METABOLITESALERE SAN DIEGO, INC.DIODOA-184DOA6090157R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12017-04-200

Event Narratives#

N

Patient 1

INVESTIGATION CONCLUSION: THE CUSTOMER'S OBSERVATION WAS NOT REPLICATED IN HOUSE WITH RETENTION PRODUCTS. RETENTION DEVICES WERE TESTED WITH COC AND THC +50% CUTOFF CONTROL AND 3X CUTOFF CONTROL. ALL COC AND THC RESULTS WERE POSITIVE AT READ TIME AND MET QC SPECIFICATIONS. NO FALSE NEGATIVE 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.

D

Patient 1

THE CUSTOMER REPORTED A FALSE NEGATIVE COCAINE AND THC RESULT ON A PATIENT. AN ORAL FLUID SAMPLE WAS SENT TO THE LABORATORY AND PRODUCED A BENZOYLECGONINE (COCAINE) RESULT OF 63 NG/ML AND A THC RESULT OF 7 NG/ML. THE APPROPRIATE URINE SAMPLE TYPE WAS USED FOR THE MULTIDIP 8 DRUG TEST. HOWEVER, ORAL FLUID IS NOT INDICATED FOR THIS TEST. THEREFORE, A DIRECT COMPARISON BETWEEN THE RESULTS PROVIDED COULD NOT BE CONDUCTED. THERE WAS NO TREATMENT OR INTERVENTION ADMINISTERED BASED ON EITHER SET OF RESULTS. NO REPORTED ADVERSE PATIENT SEQUELA.