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 2017-10-23 for DIMENSION VISTA 1500 manufactured by Siemens Healthcare Diagnostics Inc..
[90755307]
The customer contacted the siemens customer care center (ccc) to report the discordant carbon dioxide result. Quality control (qc) was within range. The ccc remotely aligned sample 3 and reagent 5 probes. The customer inspected sample 3 probe and found that it was bent. The customer replaced sample 3 probe, aligned it and ran quick check, which passed. The customer re-ran qc for server 3, which was acceptable. A siemens customer service engineer (cse) was dispatched to the customer's site. The cse verified all servers. Qc was within range after replacing s3. The cause of the discordant carbon dioxide results is unknown. The instrument is performing according to the specifications. No further evaluation of this device is required.
Patient Sequence No: 1, Text Type: N, H10
[90755308]
A discordant falsely low, carbon dioxide (co2) result was obtained on one patient sample on a dimension vista 1500 instrument. The discordant result was not reported to the physician(s). The sample was repeated on an alternate instrument. The corrected result was reported to the physician(s). There are no reports of patient intervention or adverse health consequences due to the discordant co2 result.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2517506-2017-00787 |
| MDR Report Key | 6969285 |
| Report Source | HEALTH PROFESSIONAL,USER FACI |
| Date Received | 2017-10-23 |
| Date of Report | 2017-10-23 |
| Date of Event | 2017-09-29 |
| Date Mfgr Received | 2017-09-29 |
| Device Manufacturer Date | 2012-09-27 |
| Date Added to Maude | 2017-10-23 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 0 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MARGARITA KARAN |
| Manufacturer Street | 511 BENEDICT AVENUE |
| Manufacturer City | TARRYTOWN NY 10591 |
| Manufacturer Country | US |
| Manufacturer Postal | 10591 |
| Manufacturer Phone | 9145243105 |
| Manufacturer G1 | SIEMENS HEALTHCARE DIAGNOSTICS INC. |
| Manufacturer Street | 101 SILVERMINE ROAD REGISTRATION NUMBER: 1226181 |
| Manufacturer City | BROOKFIELD CT 06804 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 06804 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | DIMENSION VISTA 1500 |
| Generic Name | DIMENSION VISTA 1500 |
| Product Code | CHS |
| Date Received | 2017-10-23 |
| Model Number | DIMENSION VISTA 1500 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 0 |
| Device Event Key | 0 |
| Manufacturer | SIEMENS HEALTHCARE DIAGNOSTICS INC. |
| Manufacturer Address | 500 GBC DRIVE PO BOX 6101 NEWARK DE 197146101 US 197146101 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2017-10-23 |