HEA 1.2 BEADCHIP KIT, SLIDE 800-20202-08

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-06-30 for HEA 1.2 BEADCHIP KIT, SLIDE 800-20202-08 manufactured by Bioarray Solutions Ltd..

Event Text Entries

[79141218] Discrepancy 1 results: sample (b)(6). The molecular presence of mixed base adenine and guanine at the polymorphic site that is indicative of the kidd (jk) antigen would normally represent a heterozygous jk(a+b+) individual1, as was reported by hea bead chips heac4321_6 and head7186_1. However, the individual is also heterozygous for a polymorphism of the intron 5 splice acceptor site (ivs5as, isbt=jk*02n. 01, also known as c. 342-1g>a). The adenine at this site could silence the expression of the jkb antigen from the same allele. The silencing of jkb, as first reported by lucien et al. 2, would leave no expression of the jkb antigen on the surface of the erythrocyte. Jknull is listed as a limitation of the precisetype? Hea beadchip test as listed in the package insert (part number 190-20210). Discrepancy 2 results: sample (b)(6). The molecular presence of only adenine at the polymorphic site that is indicative of the kidd (jk) antigen would normally represent a homozygous jk(b+) individual1, as was reported by hea bead chips head7188_8 and head8258_5. However, the individual is also homozygous for a polymorphism of the intron 5 splice acceptor site (ivs5as, isbt=jk*02n. 01, also known as c. 342-1g>a) that silences the expression of the jkb antigen. The silencing of jkb, as first reported by lucien et al. 2, would leave no expression of the jkb antigen on the surface of the erythrocyte. Jknull is listed as a limitation of the precisetype? Hea bead chip test as listed in the package insert (part number 190-20210).
Patient Sequence No: 1, Text Type: N, H10


[79141219] The customer reported two possible discrepancies. The donor is jkb+ using the bioarray hea molecular bead chip kit; serology results were jkb-.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3005967741-2017-00021
MDR Report Key6682136
Date Received2017-06-30
Date of Report2017-06-30
Date of Event2017-06-05
Date Mfgr Received2017-06-05
Device Manufacturer Date2016-09-29
Date Added to Maude2017-06-30
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationMEDICAL TECHNOLOGIST
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. LUZ VILLAMIZAR
Manufacturer Street35 TECHNOLOGY DRIVE SUITE 100
Manufacturer CityWARREN NJ 07059
Manufacturer CountryUS
Manufacturer Postal07059
Manufacturer Phone9084449591
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameHEA 1.2 BEADCHIP KIT, SLIDE
Generic NameHEA 1.2 BEADCHIP KIT, SLIDE
Product CodePEP
Date Received2017-06-30
Model Number800-20202-08
Catalog Number800-20202-08
Lot Number17-50-V
Device Expiration Date2017-07-31
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerBIOARRAY SOLUTIONS LTD.
Manufacturer Address35 TECHNOLOGY DRIVE SUITE 100 WARREN NJ 07059 US 07059


Patients

Patient NumberTreatmentOutcomeDate
10 2017-06-30

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