MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional report with the FDA on 2017-12-01 for ARCHITECT CA 125 II 02K45-28 manufactured by Abbott Laboratories.
[93710836]
An evaluation is in process. A follow up report will be submitted when the evaluation is complete. See manufacturing report number 1415939-2017-00209 for lot 74016m800.
Patient Sequence No: 1, Text Type: N, H10
[93710837]
The customer observed falsely elevated ca125 results on the architect i2000sr analyzer. The following data was provided for one (b)(6) postmenopausal female patient with one ovary removed previously: with lot 74016m800 initial > 1000. 0, repeats 1010. 9, > 1000. 0, 1024. 5, with lot 75007m800 initial 972. 7, repeats 117. 2, 64. 6, 31. 8, 12. 7, 613. 1, 380. 7 and 121. 3. There was no impact to patient management reported.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1415939-2017-00210 |
| MDR Report Key | 7076482 |
| Report Source | FOREIGN,HEALTH PROFESSIONAL |
| Date Received | 2017-12-01 |
| Date of Report | 2017-12-18 |
| Date of Event | 2017-11-05 |
| Date Mfgr Received | 2017-12-11 |
| Device Manufacturer Date | 2017-06-01 |
| Date Added to Maude | 2017-12-01 |
| 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 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | NOEMI ROMERO-KONDOS, RN BSN |
| Manufacturer Street | 100 ABBOTT PARK ROAD DEPT. 09B9, LCCP1-3 |
| Manufacturer City | ABBOTT PARK IL 600643537 |
| Manufacturer Country | US |
| Manufacturer Postal | 600643537 |
| Manufacturer Phone | 224667-512 |
| Manufacturer G1 | ABBOTT LABORATORIES |
| Manufacturer Street | 100 ABBOTT PARK ROAD |
| Manufacturer City | ABBOTT PARK IL 600643500 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 600643500 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ARCHITECT CA 125 II |
| Generic Name | OC 125 DEFINED ANTIGEN |
| Product Code | LTK |
| Date Received | 2017-12-01 |
| Catalog Number | 02K45-28 |
| Lot Number | 75007M800 |
| Device Expiration Date | 2018-04-06 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ABBOTT LABORATORIES |
| Manufacturer Address | 100 ABBOTT PARK ROAD ABBOTT PARK IL 600643500 US 600643500 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2017-12-01 |