TESTPACK PLUS HCG-URINE 3C07-16

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01,06 report with the FDA on 2006-03-17 for TESTPACK PLUS HCG-URINE 3C07-16 manufactured by Abbott Laboratories.

Event Text Entries

[21711180] The account stated a pt sample generated a negative testpack plus hcg urine result when read at 5 minutes but after 10 minutes, the result changed to positive. Both the control bar and end of assay window contained color at 5 minutes, indicating the assay was valid. It is unk whether the urine sample was a first morning or random sample. The pt tested positive on quantitative hcg. There was no impact to pt management.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1451914-2006-00001
MDR Report Key689611
Report Source01,06
Date Received2006-03-17
Date of Report2005-12-03
Date of Event2005-12-03
Date Mfgr Received2005-12-03
Device Manufacturer Date2005-09-01
Date Added to Maude2006-03-21
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 Location0
Manufacturer ContactDR. DAVID BARCH, D-09Y6, AP6C-2
Manufacturer Street100 ABBOTT PARK ROAD
Manufacturer CityABBOTT PARK IL 600646092
Manufacturer CountryUS
Manufacturer Postal600646092
Manufacturer Phone8479379328
Manufacturer G1*
Manufacturer Street*
Manufacturer City*
Manufacturer Country*
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameTESTPACK PLUS HCG-URINE
Generic NameRAPID PREGNANCY TEST
Product CodeJHJ
Date Received2006-03-17
Model NumberNA
Catalog Number3C07-16
Lot Number19473M200
ID NumberNA
Device Expiration Date2006-12-20
OperatorUNKNOWN
Device AvailabilityN
Device Eval'ed by MfgrY
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key678788
ManufacturerABBOTT LABORATORIES
Manufacturer AddressINTERSECTION U.S. 41 & 22ND ST NORTH CHICAGO IL 60064 US
Baseline Brand NameTESTPACK +PLUS HCG URINE
Baseline Generic NameQUALITATIVE URINE PREGNANCY TEST
Baseline Model NoNA
Baseline Catalog No3C07-16
Baseline IDNA
Baseline Device FamilyTESTPACK +2 URINE
Baseline Shelf Life ContainedY
Baseline Shelf Life [Months]13
Baseline PMA FlagN
Baseline 510K PMNY
Premarket NotificationK954029
Baseline PreamendmentN
Baseline TransitionalN
510k ExemptN


Patients

Patient NumberTreatmentOutcomeDate
10 2006-03-17

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