DIMENSION VISTA? K800A SMN10484429

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,user faci report with the FDA on 2018-03-14 for DIMENSION VISTA? K800A SMN10484429 manufactured by Siemens Healthcare Diagnostics Inc..

Event Text Entries

[102453979] Mdr 2517506-2018-00175 was also filed for the same customer inquiry. The customer contacted the siemens customer care center for the discordant, imprecise (k) results on the dimension vista instrument. Siemens headquarters support center (hsc) has completed the investigation of the incident. Hsc evaluated the data provided. The cause of the discrepant imprecise k results cannot be confirmed; however, it is specific to the patient. No product problem has been identified. Qc was within range at the time of testing. The device is performing within specifications. No further evaluation of the device is required.
Patient Sequence No: 1, Text Type: N, H10


[102453980] Discordant, imprecise potassium (k) results were obtained on a patient sample on the dimension vista 500 instrument. There are no reports of patient intervention or adverse health consequences due to the discordant, imprecise potassium results.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2517506-2018-00177
MDR Report Key7339706
Report SourceHEALTH PROFESSIONAL,USER FACI
Date Received2018-03-14
Date of Report2018-03-14
Date of Event2018-02-15
Date Mfgr Received2018-02-15
Device Manufacturer Date2017-11-06
Date Added to Maude2018-03-14
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 ContactJAMES MORGERA
Manufacturer Street500 GBC DRIVE PO BOX 6101
Manufacturer CityNEWARK DE 197146101
Manufacturer CountryUS
Manufacturer Postal197146101
Manufacturer Phone3026318356
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS INC.
Manufacturer Street500 GBC DRIVE PO BOX 6101
Manufacturer CityNEWARK DE 197146101
Manufacturer CountryUS
Manufacturer Postal Code197146101
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameDIMENSION VISTA?
Generic NameDIMENSION VISTA?V-LYTE? INTEGRATED MULTISENSOR NA+ K+ CL-
Product CodeCEM
Date Received2018-03-14
Catalog NumberK800A SMN10484429
Lot Number7LD824
Device Expiration Date2018-05-05
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS INC.
Manufacturer Address500 GBC DRIVE PO BOX 6101 NEWARK DE 197146101 US 197146101


Patients

Patient NumberTreatmentOutcomeDate
10 2018-03-14

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