SPECIFIC/TOTAL IGE EIA 74155

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-07-11 for SPECIFIC/TOTAL IGE EIA 74155 manufactured by Hycor Biomedical.

Event Text Entries

[114148453] The distributor reported the shipment containing stop solution (1n sodium hydroxide) was received with a stained carton, suggesting leakage of an item in the package. Photographic evidence provided by the distributor showed two stained cartons. Pictures of the stop solution bottles showed that one bottle had a visibly lower volume than the bottle from the other carton. Hycor requested products be returned for investigation. The investigation demonstrated one of the two returned bottles was leaking as determined by a vacuum test. Further investigation determined that the stop solution bottles used in the kit lot were manufactured during a time when the automatic capping system malfunctioned leading to a temporary process to hand tighten the caps. A stop ship order for product containing stop solution bottles manufactured during the time period when the capping system was not functioning correctly was initiated 05/31/2018. All impacted bottles of stop solution have been reprocessed ensuring that the cap is sealed with the proper torque. A sampling of product was tested in a vacuum chamber to determine if leaking was present, no leaks were detected. Hycor is initiating a recall action to inform distributors that leaking stop solution bottles have been reported during transit and that they should inspect remaining inventory for evidence of leakage prior to further distribution. There were no adverse outcomes reported to hycor. However, out of an abundance of caution, we are filing an mdr. Delay in reporting was due to an employee confusing this event with a previously reported similar event, review of records determined that this event should also have been reported. [(b)(4)].
Patient Sequence No: 1, Text Type: N, H10


[114148454] The distributor reported the shipment containing stop solution (1n sodium hydroxide) was received with a stained carton, suggesting leakage of an item in the package. Photographic evidence provided by the distributor showed two stained cartons. One carton was stained on the bottom panel, the second carton was stained on the top panel indicating that a bottle from one carton likely leaked and stained the lower carton. Pictures of the stop solution bottles showed that one bottle had a visibly lower volume than the bottle from the other carton. (the container is filled to 300 ml in a 500 ml bottle). Hycor requested products be returned for investigation. Hycor received the damaged products on 06/01/2018. The investigation demonstrated one of the two returned bottles was leaking as determined by a vacuum test. There were no adverse outcomes reported to hycor. However, out of an abundance of caution, we are filing an mdr.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2016473-2018-00002
MDR Report Key7679461
Date Received2018-07-11
Date of Report2018-07-11
Date of Event2018-02-19
Date Mfgr Received2018-02-19
Device Manufacturer Date2017-08-09
Date Added to Maude2018-07-11
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 TARA VIVIANI
Manufacturer Street7272 CHAPMAN AVE
Manufacturer CityGARDEN GROVE CA 92841
Manufacturer CountryUS
Manufacturer Postal92841
Manufacturer Phone7149333027
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameSPECIFIC/TOTAL IGE EIA
Generic NameSPECIFIC/TOTAL IGE EIA
Product CodeDHB
Date Received2018-07-11
Returned To Mfg2018-06-01
Catalog Number74155
Lot Number154104-9
Device Expiration Date2018-11-30
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerHYCOR BIOMEDICAL
Manufacturer Address7272 CHAPMAN AVE GARDEN GROVE CA 92841 US 92841


Patients

Patient NumberTreatmentOutcomeDate
10 2018-07-11

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