INNOVANCE? D-DIMER 10445982

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,user faci report with the FDA on 2017-09-13 for INNOVANCE? D-DIMER 10445982 manufactured by Siemens Healthcare Diagnostics Products Gmbh.

Event Text Entries

[86117774] A siemens healthcare diagnostics inc. (siemens) customer service engineer (cse) and a technical application specialist (tas) were dispatched to the customer's site to determine the cause of the potential false negative d-dimer results on the bcs xp system. During the investigation, the cse observed that the calibration curve, used to run patient samples, on the bcs xp system was unacceptable. The cse changed the reagent lot, calibrated the system, replaced the sample probes, and flushed the bcs xp system of the barbicide disinfectant cleaner. The precision test, validation and lamp were within specifications. The internal qc recovered within expected ranges. Upon further investigation, siemens determined that the customer is using recycled cuvette rotors. Based on the bcs? Xp system's instruction manual, cuvettes are only intended for single use. If used more than once, this could result in inaccurate measurement results. The use of recycled cuvette rotors is a user error and potentially contributed to the discordant result. Siemens has instructed the customer to discontinue the use of recycled cuvette rotors. The system is performing according to specifications. No further evaluation of this system is required. Mdr 9610806-2017-00098, mdr 9610806-2017-00099, mdr 9610806-2017-00100, and mdr 9610806-2017-00102 were filed for the same event.
Patient Sequence No: 1, Text Type: N, H10


[86117775] Multiple potential false negative d-dimer results were obtained on multiple patient samples using an unacceptable calibration curve on the bcs xp system. The d-dimer results were reported to the physician(s), who did not question the results. The affected patient samples were not reruned and corrected reports were not provided to the physician(s). The correct results for the affected patients are unknown. There are no known reports of patient intervention or adverse health consequences due to the potential false negative d-dimer results obtained on the patient samples on the bcs xp system.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9610806-2017-00101
MDR Report Key6861361
Report SourceHEALTH PROFESSIONAL,USER FACI
Date Received2017-09-13
Date of Report2017-10-16
Date of Event2017-08-17
Date Mfgr Received2017-09-18
Date Added to Maude2017-09-13
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 ContactCHRISTINA LAM
Manufacturer Street511 BENEDICT AVE
Manufacturer CityTARRYTOWN NY 10591
Manufacturer CountryUS
Manufacturer Postal10591
Manufacturer Phone9145243504
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS PRODUCTS GMBH
Manufacturer StreetEMIL-VON-BEHRING-STR. 76
Manufacturer CityMARBURG, D-35041
Manufacturer CountryGM
Manufacturer Postal CodeD-35041
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameINNOVANCE? D-DIMER
Generic NameINNOVANCE? D-DIMER
Product CodeDAP
Date Received2017-09-13
Model NumberINNOVANCE? D-DIMER
Catalog Number10445982
Lot Number47386
Device Expiration Date2019-02-26
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS PRODUCTS GMBH
Manufacturer AddressEMIL-VON-BEHRING-STR. 76 MARBURG, D-35041 GM D-35041


Patients

Patient NumberTreatmentOutcomeDate
10 2017-09-13

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