CLINICAL CHEMISTRY CALCIUM 3L79-21 03L79-21

MAUDE Adverse Event Report

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 2018-06-06 for CLINICAL CHEMISTRY CALCIUM 3L79-21 03L79-21 manufactured by Abbott Manufacturing Inc.

Event Text Entries

[110583451] An evaluation is in process. A follow-up report will be submitted when the evaluation is complete. There is no further patient information provided by the customer.
Patient Sequence No: 1, Text Type: N, H10


[110583452] The customer reported falsely decreased calcium (ca) results on one patient. The results provided were: initial draw = 1. 39mmol/l / repeat = 1. 38mmol/l / new draw same day = 2. 25mmol/l / retest of original sample = 2. 32mmol/l. There was no reported impact to patient management.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1628664-2018-00222
MDR Report Key7573682
Report SourceFOREIGN,HEALTH PROFESSIONAL
Date Received2018-06-06
Date of Report2018-09-06
Date Mfgr Received2018-08-20
Device Manufacturer Date2017-08-15
Date Added to Maude2018-06-06
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 ContactNOEMI ROMERO-KONDOS, RN BSN
Manufacturer Street100 ABBOTT PARK ROAD DEPT. 09B9, LCCP1-3
Manufacturer CityABBOTT PARK IL 600643537
Manufacturer CountryUS
Manufacturer Postal600643537
Manufacturer Phone224667-512
Manufacturer G1ABBOTT MANUFACTURING INC
Manufacturer Street1921 HURD DRIVE
Manufacturer CityIRVING TX 75038
Manufacturer CountryUS
Manufacturer Postal Code75038
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameCLINICAL CHEMISTRY CALCIUM
Generic NameCALCIUM
Product CodeCJY
Date Received2018-06-06
Model Number3L79-21
Catalog Number03L79-21
Lot Number20039UN17
Device Expiration Date2018-07-18
OperatorHEALTH PROFESSIONAL
Device Availability*
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerABBOTT MANUFACTURING INC
Manufacturer Address1921 HURD DRIVE IRVING TX 75038 US 75038


Patients

Patient NumberTreatmentOutcomeDate
10 2018-06-06

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