CAPTURE-S *

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 2006-08-03 for CAPTURE-S * manufactured by Immucor, Inc..

Event Text Entries

[513102] Customer states that they are getting unexpected negative reactions with positive control cells, lot # 252008, exp. 2/11/07 of capture s when performing their lot to lot qc capture s indicator cells, lot #229018.
Patient Sequence No: 1, Text Type: D, B5


[7799476] The customer's previous lot of positive control, lot #252006, and negative control, lot #251005, used for daily quality control performed as expected, using the same lot of indicator cells. The old lots of controls tested with a new lot of indicator cells, lot #229019, performed as expected. Retention capture -s indicator cells, lot 229018 were tested on an in-house semi-automated instrument with retention capture-s plates, lot s098; capture-s reactive control serum, lot 252007; capture-s nonreactive control serum, lot 251006 and in-house donor samples. In-house donor samples were nonreactive in all testing performed, as expected. Investigation is ongoing.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1034569-2006-00075
MDR Report Key761444
Report Source06
Date Received2006-08-03
Date of Report2006-08-02
Date of Event2006-07-14
Date Mfgr Received2006-07-14
Date Added to Maude2006-09-19
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 Location0
Manufacturer ContactSCOTT WEBBER
Manufacturer Street3130 GATEWAY DR
Manufacturer CityNORCROSS GA 30071
Manufacturer CountryUS
Manufacturer Postal30071
Manufacturer Phone7704412051
Manufacturer G1*
Manufacturer Street*
Manufacturer City*
Manufacturer Country*
Single Use3
Remedial ActionRC
Previous Use Code3
Removal Correction NumberFA-06-06
Event Type3
Type of Report3

Device Details

Brand NameCAPTURE-S
Generic NameGMQ
Product CodeGMQ
Date Received2006-08-03
Model Number*
Catalog Number*
Lot Number229018
ID Number*
Device Expiration Date2006-07-14
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key749351
ManufacturerIMMUCOR, INC.
Manufacturer Address* NORCROSS GA * US


Patients

Patient NumberTreatmentOutcomeDate
10 2006-08-03

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