COBAS 8000 E 602 MODULE E602 05990378001

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 2017-10-11 for COBAS 8000 E 602 MODULE E602 05990378001 manufactured by Roche Diagnostics.

Event Text Entries

[90309766] (b)(4). This event occurred in (b)(6). (b)(6).
Patient Sequence No: 1, Text Type: N, H10


[90309767] The customer received a questionable low syphilis result for one patient sample. The initial result was 0. 844 coi and was reported outside the laboratory. The result was later questioned. The sample was repeated on (b)(6) 2017 and the result was 232. 2 coi. The reported result was corrected. There was no allegation of an adverse event. The reagent lot number was 181655 with an expiration date of 30-sep-2017.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1823260-2017-02275
MDR Report Key6940973
Report SourceFOREIGN,HEALTH PROFESSIONAL,U
Date Received2017-10-11
Date of Report2017-11-27
Date of Event2017-09-19
Date Mfgr Received2017-09-25
Date Added to Maude2017-10-11
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag3
Reprocessed and Reused Flag0
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 G1HITACHI HIGH TECH CORP.
Manufacturer Street882 ICHIGE HITACHINAKA NA
Manufacturer CityIBARAKI 312-8504
Manufacturer CountryJA
Manufacturer Postal Code312-8504
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameCOBAS 8000 E 602 MODULE
Generic NameIMMUNOCHEMISTRY ANALYZER
Product CodeGMT
Date Received2017-10-11
Model NumberE602
Catalog Number05990378001
Lot NumberNA
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No0
Device Event Key0
ManufacturerROCHE DIAGNOSTICS
Manufacturer Address9115 HAGUE ROAD NA INDIANAPOLIS IN 462500457 US 462500457


Patients

Patient NumberTreatmentOutcomeDate
10 2017-10-11

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