HEA 1.2 BEADCHIP KIT, SLIDE 800-20202-08

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-12-21 for HEA 1.2 BEADCHIP KIT, SLIDE 800-20202-08 manufactured by Bioarray Solutions Ltd..

Event Text Entries

[96127149] Sequencing interpretation: sample (b)(6): the results of precisetype hea beadchip heaf2280_5 represent a heterozygous jkab individual1. However, the individual is also heterozygous for a polymorphism of the intron 5 splice acceptor site (ivs5as, isbt=jk*02n. 01, also known as c. 342-1g>a) that silences the expression of the jkb antigen. The silencing of jkb, as first reported by lucien et al. 2, would leave no expression of the jkb antigen on the surface of the erythrocyte. Jknull is listed as a limitation of the precisetype? Hea beadchip test as listed in the package insert (part number 190-20210). Sample (b)(6): the results of precisetype hea beadchip heaf2280_3 represent a heterozygous jkab individual1. However, the individual is also heterozygous for a polymorphism of the intron 5 splice acceptor site (ivs5as, isbt=jk*02n. 01, also known as c. 342-1g>a) that silences the expression of the jkb antigen. The silencing of jkb, as first reported by lucien et al. 2, would leave no expression of the jkb antigen on the surface of the erythrocyte. Jknull is listed as a limitation of the precisetype? Hea beadchip test as listed in the package insert (part number 190-20210).
Patient Sequence No: 1, Text Type: N, H10


[96127150] The customer reported a possible discrepancy. Two donor samples type jkb+ using the bioarray hea molecular beadchip kit; serology results were jkb-.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3005967741-2017-00028
MDR Report Key7137926
Date Received2017-12-21
Date of Report2017-12-21
Date of Event2017-12-01
Date Mfgr Received2017-12-01
Device Manufacturer Date2017-09-22
Date Added to Maude2017-12-21
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationMEDICAL TECHNOLOGIST
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. LUZ VILLAMIZAR
Manufacturer Street35 TECHNOLOGY DRIVE SUITE 100
Manufacturer CityWARREN NJ 07059
Manufacturer CountryUS
Manufacturer Postal07059
Manufacturer Phone9084449591
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameHEA 1.2 BEADCHIP KIT, SLIDE
Generic NameHEA 1.2 BEADCHIP KIT, SLIDE
Product CodePEP
Date Received2017-12-21
Model Number800-20202-08
Catalog Number800-20202-08
Lot Number18-96-V
Device Expiration Date2018-12-31
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerBIOARRAY SOLUTIONS LTD.
Manufacturer Address35 TECHNOLOGY DRIVE SUITE 100 WARREN NJ 07059 US 07059


Patients

Patient NumberTreatmentOutcomeDate
10 2017-12-21

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