RUBELLA IGG - IGG ANTIBODIES TO RUBELLA VIRUS 07027770190

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 2018-02-01 for RUBELLA IGG - IGG ANTIBODIES TO RUBELLA VIRUS 07027770190 manufactured by Roche Diagnostics.

Event Text Entries

[99005275] This event occurred in (b)(6). (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[99005276] The customer complained of discrepant results for 1 patient sample tested for elecsys rubella igg immunoassay (rubella igg) on a cobas e 801 module. The discrepant results are from 2 different reagent lots and the customer is not sure which result is correct as the patient was considered "immunized" using 1 reagent lot and "not immunized" from the other reagent lot. The customer also decided to reanalyze 20 samples from other patients on the 2 different reagent lots of rubella igg and one additional reagent lot of rubella igg. These samples were also sent to an external laboratory and tested by the siemens and blot method. Based on the data provided, the results for 11 patient samples were discrepant between the rubella igg reagent lots and the siemens and blot methods. This medwatch will cover rubella igg reagent lot 206165. Refer to medwatch with patient identifier (b)(6) for information on rubella igg reagent lot 267449 and medwatch with patient identifier (b)(6) for information on rubella igg reagent lot 282957. The patient had been tested on (b)(6) 2017 with reagent lot 206165 and the rubella igg result was 15 ui/ml (positive). When the patient was tested in (b)(6) 2018 with reagent lot 267449 the rubella igg result was 6. 56 ui/ml (negative). On (b)(6) 2018 the customer repeated the patient sample from (b)(6) 2017 using reagent lot 267449 and the result was 8. 23 ui/ml (negative). On (b)(6) 2018 the customer ran the patient sample from (b)(6) 2017 with reagent lot 267449 and the result was 8. 83 ui/ml (negative). No comparison results were provided for this sample. On (b)(6) 2018 the customer ran the patient sample from (b)(6) 2017 with reagent lot 267449 and the result was 7. 03 ui/ml (negative). No comparison results were provided for this sample. There was no allegation that an adverse event occurred. The e801 serial number was not provided.
Patient Sequence No: 1, Text Type: D, B5


[117885150] Based on the information available, a general reagent issue is not suspected. Product labeling comprehensively describes and addresses the issue of lot-to-lot variability and how to handle patient results that are close to the cut off. A product problem was not detected. The investigation was unable to find a definitive root cause for this event.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1823260-2018-00293
MDR Report Key7233478
Report SourceFOREIGN,HEALTH PROFESSIONAL,U
Date Received2018-02-01
Date of Report2018-03-19
Date of Event2017-09-11
Date Mfgr Received2018-01-15
Date Added to Maude2018-02-01
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 NameRUBELLA IGG - IGG ANTIBODIES TO RUBELLA VIRUS
Generic NameENZYME LINKED IMMUNOABSORBENT ASSAY, RUBELLA
Product CodeLFX
Date Received2018-02-01
Model NumberNA
Catalog Number07027770190
Lot Number206165
ID NumberNA
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 2018-02-01

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