PRISM 6 CHANNEL ANALYZER 06A36-04

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 2018-07-16 for PRISM 6 CHANNEL ANALYZER 06A36-04 manufactured by Abbott Manufacturing Inc.

Event Text Entries

[114159715] All available patient information was included. Additional patient details are not available. An evaluation is in process. A final report will be submitted when the evaluation is complete. Concomitant medical products: prism tray ln05a07-01, lots 83020m500; 85076m500 prism (b)(6) ln 06a52-48, lot 84277li00.
Patient Sequence No: 1, Text Type: N, H10


[114159716] The customer reported (b)(6) prism (b)(6) results for multiple samples on the prism analyzer while using a new lot of prism (b)(6) trays. The customer provided the following examples (first result is with tray lot 83020m500, repeat result on 85077m500 and prism sn (b)(4)): sample 1: 0. 99 s/co, repeat 1. 03 s/co; sample 2: 0. 83 s/co, repeat 1. 03 s/co; sample 3: 0. 99 s/co, repeat 1. 09 s/co. The retest results match the clinical presentation of the patient. No adverse impact to donor management was reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1628664-2018-00271
MDR Report Key7690949
Report SourceFOREIGN,HEALTH PROFESSIONAL
Date Received2018-07-16
Date of Report2018-11-08
Date Mfgr Received2018-11-07
Date Added to Maude2018-07-16
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
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 NamePRISM 6 CHANNEL ANALYZER
Generic NameAUTOMATED IMMUNOASSAY ANALYZER
Product CodeMZA
Date Received2018-07-16
Catalog Number06A36-04
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
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 2018-07-16

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