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 2017-08-25 for MULTI-DRUG 5 PANEL SCREEN TEST DOA-654 manufactured by Alere San Diego, Inc..
[83749177]
Investigation conclusion: the customer's observation was not replicated in-house with retention products. Retention devices were tested with in-house drug free donor urine and all devices showed expected negative results for all analytes at read time. 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
[83749178]
The customer reported 40 occurrences of false positive results on all drugs using the multi-drug 5 panel screen on random donors starting in (b)(6) of 2017. Testing at an external laboratory provided negative results. The customer reported that out of 325 devices used, 40 produced false positive results.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2027969-2017-00136 |
| MDR Report Key | 6822697 |
| Report Source | CONSUMER,HEALTH PROFESSIONAL, |
| Date Received | 2017-08-25 |
| Date of Report | 2017-08-08 |
| Date Mfgr Received | 2017-08-08 |
| Date Added to Maude | 2017-08-25 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 0 |
| Initial Report to FDA | 0 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | YA-LING KING |
| Manufacturer Street | 9975 SUMMERS RIDGE ROAD |
| Manufacturer City | SAN DIEGO CA 92121 |
| Manufacturer Country | US |
| Manufacturer Postal | 92121 |
| Manufacturer Phone | 8588052084 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | MULTI-DRUG 5 PANEL SCREEN TEST |
| Generic Name | ENZYME IMMUNOASSAY, COCAINE AND COCAINE METABOLITES |
| Product Code | DIO |
| Date Received | 2017-08-25 |
| Model Number | DOA-654 |
| Lot Number | DOA6090505 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ALERE SAN DIEGO, INC. |
| Manufacturer Address | 9975 SUMMERS RIDGE ROAD SAN DIEGO CA 92121 US 92121 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2017-08-25 |