DIMENSION? RF520 SMN10444895

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 2018-03-22 for DIMENSION? RF520 SMN10444895 manufactured by Siemens Healthcare Diagnostics Inc..

Event Text Entries

[103182905] The customer contacted the siemens customer care center for the discordant, falsely elevated low volume mass creatinine kinase (lmmb) result on a dimension exl instrument. Siemens headquarters support center (hsc) has completed the investigation of the incident. Hsc evaluated the data provided. No instrument issues have been reported or identified. Lmmb qc was within reference ranges on the date of the incident. This event is limited to a specific patient sample. The cause of the discordant elevated lmmb result is unknown. Per the lmmb flex reagent cartridge instructions for use: "patient samples may contain heterophilic antibodies that could react with immunoassays to give falsely elevated or depressed results. This assay has been designed to minimize interference from heterophilic antibodies. Nevertheless, complete elimination of this interference from all patient specimens cannot be guaranteed. A test result that is inconsistent with the clinical picture and patient history should be interpreted with caution. " the device is performing within specifications. No further evaluation of the device is required.
Patient Sequence No: 1, Text Type: N, H10


[103182906] A discordant, falsely elevated mass creatine kinase mb isoenzyme (lmmb) was obtained on a patient serum sample on the dimension exl instrument. The result was reported to the physician who questioned the result. The same sample was sent to an alternate laboratory for testing on an alternate non-siemens methodology and a lower result was obtained. A corrected result was issued. There are no known reports of patient intervention or adverse health consequences due to the discordant, falsely elevated lmmb result.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2517506-2018-00131
MDR Report Key7361129
Report SourceHEALTH PROFESSIONAL,USER FACI
Date Received2018-03-22
Date of Report2018-03-22
Date of Event2018-02-23
Date Mfgr Received2018-02-26
Device Manufacturer Date2017-09-20
Date Added to Maude2018-03-22
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?
Generic NameDIMENSION? LMMB MASS CREATINE KINASE MB ISOENZYME FLEX? REAGENT CARTRIDGE
Product CodeJHY
Date Received2018-03-22
Catalog NumberRF520 SMN10444895
Lot NumberFA8263
Device Expiration Date2018-09-20
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 2018-03-22

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