ELECSYS CMV IGM IMMUNOASSAY

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional,u report with the FDA on 2017-08-04 for ELECSYS CMV IGM IMMUNOASSAY manufactured by Roche Diagnostics.

Event Text Entries

[81959775] This event occurred in (b)(6). (b)(4). (b)(6).
Patient Sequence No: 1, Text Type: N, H10


[81959776] The customer stated that they received questionable results for a total of 9 samples from 6 different patients tested for the elecsys cmv igg assay (cmv igg) on a cobas 6000 e 601 module (e601). The customer provided data for one patient sample that had an (b)(6) result for (b)(6) igg and the elecsys cmv igm immunoassay (cmv igm). The (b)(6) results were reported outside of the laboratory to the medical doctor. The customer stated that the involved patient had an early primary (b)(6) infection. This medwatch will apply to the cmv igm assay. Please refer to the medwatch with (b)(6) for information related to (b)(6) igg. The cmv igg results obtained with the e601 analyzer were (b)(6) compared to a clearly (b)(6) result from the abbott architect method. The recomline blot method was also performed on the sample and this had an unclear cmv igg result. The cmv igm result from the e601 analyzer was (b)(6) compared to a (b)(6) result with the recomline blot method. No adverse events were alleged to have occurred with the patient. The e601 analyzer serial (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1823260-2017-01590
MDR Report Key6766526
Report SourceFOREIGN,HEALTH PROFESSIONAL,U
Date Received2017-08-04
Date of Report2017-12-14
Date of Event2017-05-22
Date Mfgr Received2017-07-12
Date Added to Maude2017-08-04
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactNA MICHAEL LESLIE
Manufacturer Street9115 HAGUE ROAD NA
Manufacturer CityINDIANAPOLIS IN 46250
Manufacturer CountryUS
Manufacturer Postal46250
Manufacturer Phone3175214343
Manufacturer G1ROCHE DIAGNOSTICS GMBH
Manufacturer StreetSANDHOFERSTRASSE 116 NA
Manufacturer CityMANNHEIM (BADEN-WURTTEMBERG) 68305
Manufacturer CountryGM
Manufacturer Postal Code68305
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameELECSYS CMV IGM IMMUNOASSAY
Generic NameENZYME LINKED IMMUNOABSORBENT ASSAY, CYTOMEGALOVIRUS
Product CodeLFZ
Date Received2017-08-04
Model NumberNA
Catalog NumberASKU
Lot NumberASKU
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerROCHE DIAGNOSTICS
Manufacturer Address9115 HAGUE ROAD NA INDIANAPOLIS IN 462500457 US 462500457


Patients

Patient NumberTreatmentOutcomeDate
10 2017-08-04

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