CMV IGG, IGG ANTIBODIES TO CYTOMEGALOVIRUS 07027117190

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 2017-11-16 for CMV IGG, IGG ANTIBODIES TO CYTOMEGALOVIRUS 07027117190 manufactured by Roche Diagnostics.

Event Text Entries

[93380084] (b)(4). (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[93380085] The customer complained of questionable results for 1 patient tested for elecsys cmv igg assay (cmv igg) and elecsys cmv igm immunoassay (cmv igm) on a cobas 8000 e 801 module with a serial number of (b)(4). Of the data provided only the false negative result for cmv igg is a reportable malfunction. On (b)(6) 2017 sample a had a cmv igg result from a cobas e801 of 1. 16 u/ml (positive). On (b)(6) 2017 a new sample was drawn, sample b, and the cmv igg initial and rerun results from a cobas e801 were 0. 324 u/ml (negative) and 0. 315 u/ml (negative). Sample b was tested on a vidas system in the same laboratory with a cmv igg result of 10 au/ml (positive). Sample b was also tested on a vidas system in another laboratory with a cmv igg result of 10 au/ml (positive). Also on the vidas system in another laboratory a cmv igg avidity result of 0. 30 (units not provided) was obtained. Sample b was tested on a liason xl-diasorin in another laboratory with a cmv igg result of 50. 8 au/ml (positive). It was unknown if the questionable results were reported outside of the laboratory. There was no allegation of an adverse event. The customer is unable to make a conclusive decision. The investigation is currently ongoing.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1823260-2017-02631
MDR Report Key7037714
Report SourceFOREIGN,HEALTH PROFESSIONAL,U
Date Received2017-11-16
Date of Report2018-01-25
Date of Event2017-10-13
Date Mfgr Received2017-10-23
Date Added to Maude2017-11-16
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 ContactNA MICHAEL LESLIE
Manufacturer Street9115 HAGUE ROAD NA
Manufacturer CityINDIANAPOLIS IN 46250
Manufacturer CountryUS
Manufacturer Postal46250
Manufacturer Phone3175214343
Manufacturer G1ROCHE DIAGNOSTICS GMBH
Manufacturer StreetSANDHOFERSTRASSE 116 NA
Manufacturer CityMANNHEIM (BADEN-WURTTEMBERG) 68305
Manufacturer CountryGM
Manufacturer Postal Code68305
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameCMV IGG, IGG ANTIBODIES TO CYTOMEGALOVIRUS
Generic NameENZYME LINKED IMMUNOABSORBENT ASSAY, CYTOMEGALOVIRUS
Product CodeLFZ
Date Received2017-11-16
Model NumberNA
Catalog Number07027117190
Lot Number212200
ID NumberNA
Device Expiration Date2018-04-30
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerROCHE DIAGNOSTICS
Manufacturer Address9115 HAGUE ROAD NA INDIANAPOLIS IN 462500457 US 462500457


Patients

Patient NumberTreatmentOutcomeDate
10 2017-11-16

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