IMMULITE/IMMULITE 1000 BR-MA LKBR1

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,study report with the FDA on 2017-11-17 for IMMULITE/IMMULITE 1000 BR-MA LKBR1 manufactured by Siemens Healthcare Diagnostics Products, Limited.

Event Text Entries

[93070783] Siemens is evaluating the issue.
Patient Sequence No: 1, Text Type: N, H10


[93070784] Siemens technical operations internal investigation has identified that discordant falsely low results were obtained on two investigational samples on an immulite/ immulite 1000 instrument when using the br-ma (ca15-3) assay. The two investigational samples were spiked with biotin at multiple concentrations and run for investigational purposes on an immulite/immulite 1000 instrument. The results of the two samples spiked with 500 ng/ml of biotin were falsely low with a bias of -71% and -51% respectively compared to results of the two samples without biotin. There were no patient samples impacted as this was for investigational purposes only.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2432235-2017-00617
MDR Report Key7041476
Report SourceFOREIGN,STUDY
Date Received2017-11-17
Date of Report2017-12-19
Date of Event2017-10-26
Date Mfgr Received2017-12-18
Date Added to Maude2017-11-17
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 ContactAARTI AZIZ
Manufacturer Street511 BENEDICT AVENUE
Manufacturer CityTARRYTOWN NY 10591
Manufacturer CountryUS
Manufacturer Postal10591
Manufacturer Phone9145242683
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS PRODUCTS, LIMITED
Manufacturer StreetUK REGISTRATION #: 3002806944 GLYN RHONWY
Manufacturer CityLLANBERIS, CAERNARFON, GWYNEDD LL554EL
Manufacturer CountryUK
Manufacturer Postal CodeLL55 4EL
Single Use3
Previous Use Code3
Removal Correction Number2432235-12/19/2017-004-C
Event Type3
Type of Report3

Device Details

Brand NameIMMULITE/IMMULITE 1000 BR-MA
Generic NameIMMULITE/IMMULITE 1000 BR-MA
Product CodeMOI
Date Received2017-11-17
Model NumberIMMULITE/IMMULITE 1000 BR-MA
Catalog NumberLKBR1
Lot Number313
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS PRODUCTS, LIMITED
Manufacturer AddressGLYN RHONWY LLANBERIS, CAERNARFON, GWYNEDD LL554EL UK LL55 4EL


Patients

Patient NumberTreatmentOutcomeDate
10 2017-11-17

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