DONOR SCREEN HLA CLASS I AND CLASS II 303456

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a user facility report with the FDA on 2018-06-29 for DONOR SCREEN HLA CLASS I AND CLASS II 303456 manufactured by Immucor Gti Diagnostics, Inc..

Event Text Entries

[112892371] On (b)(6) 2016 complaint #: (b)(4) was received for lifecodes donorscreen-hla ds i and ds ii quickstep 90 sample run only required 1 conjugate should require 2 conjugates. Customer is concerned about the validity of the runs. On (b)(6) 2016 the r & d quickstep was set up to run 90 samples and one botle of conjugate (2 substrate) were required by the system. When 91 samples were set up, the system required 2 bottles of conjugate.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2183608-2018-00013
MDR Report Key7649946
Report SourceUSER FACILITY
Date Received2018-06-29
Date of Report2016-10-11
Date of Event2016-10-04
Date Mfgr Received2017-10-11
Date Added to Maude2018-06-29
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 ContactMS JOAN RIXE
Manufacturer Street20925 CROSSROADS CIRCLE
Manufacturer CityWAUKESHA WI 53186
Manufacturer CountryUS
Manufacturer Postal53186
Manufacturer Phone2627541016
Manufacturer G1IMMUCOR GTI DIAGNOSTICS, INC.
Manufacturer Street20925 CROSSROADS CIRCLE
Manufacturer CityWAUKESHA WI 53186
Manufacturer CountryUS
Manufacturer Postal Code53186
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameDONOR SCREEN HLA CLASS I AND CLASS II
Generic NameDONORSCREEN HLA CLASS I AND CLASS II
Product CodeMZI
Date Received2018-06-29
Catalog Number303456
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerIMMUCOR GTI DIAGNOSTICS, INC.
Manufacturer Address20925 CROSSROADS CIRCLE WAUKESHA WI 53186 US 53186


Patients

Patient NumberTreatmentOutcomeDate
10 2018-06-29

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