MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2017-11-02 for DIRECTCHECK ACT+ ABNORMAL DCJACT-A manufactured by Accriva Diagnostics.
[91527448]
(b)(4). Since this complaint is not related to product performance and the device will not be evaluated, this submission is considered a final report.
Patient Sequence No: 1, Text Type: N, H10
[91527449]
Healthcare professional reported that an end user sustained an injury during reconstitution of a directcheck quality control. This control is packaged in a glass ampule inside a crushable plastic dropped vial containing diluent. The end-user was not wearing gloves and did not use the protective sleeve provided with the product. The purpose of the sleeve is to safeguard end users against potential injury during reconstitution of the control. When crushing the vial, a glass shard protruded through the dropper vial and punctured the user's right thumb. The end user immediately washed the area with soap and water and covered the cut with a band aid. No further medical attention was sought. No significant blood loss or medical complications were reported.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2250033-2017-00006 |
| MDR Report Key | 6996101 |
| Report Source | HEALTH PROFESSIONAL |
| Date Received | 2017-11-02 |
| Date of Report | 2017-11-02 |
| Date of Event | 2017-10-24 |
| Date Mfgr Received | 2017-10-24 |
| Device Manufacturer Date | 2017-03-01 |
| Date Added to Maude | 2017-11-02 |
| 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 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | JON MCDERMED |
| Manufacturer Street | 6260 SEQUENCE DRIVE |
| Manufacturer City | SAN DIEGO CA 92121 |
| Manufacturer Country | US |
| Manufacturer Postal | 92121 |
| Manufacturer Phone | 8582632490 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | DIRECTCHECK ACT+ ABNORMAL |
| Generic Name | PLASMA, COAGULATION CONTROL |
| Product Code | GGN |
| Date Received | 2017-11-02 |
| Model Number | DCJACT-A |
| Catalog Number | DCJACT-A |
| Lot Number | C7DCA008 |
| Device Expiration Date | 2018-03-31 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ACCRIVA DIAGNOSTICS |
| Manufacturer Address | 6260 SEQUENCE DRIVE SAN DIEGO CA 92121 US 92121 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2017-11-02 |