VITROS CHEMISTRY PRODUCTS PHYT SLIDES 8298671

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-07-20 for VITROS CHEMISTRY PRODUCTS PHYT SLIDES 8298671 manufactured by Ortho-clinical Diagnostics.

Event Text Entries

[114820127] The investigation determined that lower and higher than expected results were obtained from quality control fluids using 3 different lots of vitros phenytoin (phyt) micro slides on a vitros 5600 integrated system. The assignable cause of the event is unknown. Historical quality control results indicated that three of the four vitros phyt slide lots were exhibiting some magnitude of within-lab imprecision within the timeframe of the event. Since three different vitros phyt slide lots were affected, it is unlikely a slide related issue contributed to the event, however, slide related issues cannot be completely ruled out as contributing to the event. In addition, ongoing tracking and trending of complaints has not identified any signals that would suggest there is a systemic issue with vitros phyt reagent. The tsc did not investigate the customer? S sample handling protocol, therefore, improper pre-analytical sample handling protocol cannot be ruled out as contributing to the event. Finally, an ortho fe replaced the immunowash metering pump of the vitros 5600 system, however, since the pre-service vitros crbm and phyt within-run precision tests were acceptable, it is unknown if an analyzer related issue contributed to the event. Acceptable vitros phyt performance has been observed since the service action performed on 14 june 2018.
Patient Sequence No: 1, Text Type: N, H10


[114820128] A customer obtained lower and higher than expected results from quality control fluids using 3 different lots of vitros phenytoin (phyt) micro slides on a vitros 5600 integrated system. Vitros phyt slide lot 2615-0166-7348. Vitros tdm pv iii x6157 result of 19. 9 ug/ml vs. The expected result of 26. 60 ug/ml. Vitros phyt slide lot 2615-0166-7390 vitros tdm pv iii x6157 results of 33. 7, 34. 4, 32. 7, and 32. 3 ug/ml vs. The expected result of 26. 60 ug/ml. Vitros phyt slide lot 2615-0166-9043. Vitros tdm pv iii x6157 result of 19. 8 ug/ml vs. The expected result of 26. 60 ug/ml. Biased results of the direction and magnitude observed may lead to inappropriate physician action if occurred undetected. The customer made no allegations that patient sample results were affected and there was no allegation of patient harm. However, the investigation cannot conclude that patient sample results had not been affected or would not be affected if the event were to recur undetected. This report is number 1 of 6 mdr? S for this event. Six (6) 3500a forms are being submitted for this event as 6 devices were involved. This report corresponds to ortho clinical diagnostics inc. (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1319809-2018-00092
MDR Report Key7707103
Date Received2018-07-20
Date of Report2018-07-20
Date of Event2018-04-24
Date Mfgr Received2018-06-13
Device Manufacturer Date2018-02-03
Date Added to Maude2018-07-20
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 ContactMR. JAMES A STEVENS
Manufacturer Street100 INDIGO CREEK DRIVE
Manufacturer CityROCHESTER NY 14626
Manufacturer CountryUS
Manufacturer Postal14626
Manufacturer Phone5854533000
Manufacturer G1ORTHO-CLINICAL DIAGNOSTICS
Manufacturer Street513 TECHNOLOGY BLVD.
Manufacturer CityROCHESTER NY 14652
Manufacturer CountryUS
Manufacturer Postal Code14652
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameVITROS CHEMISTRY PRODUCTS PHYT SLIDES
Generic NameIN-VITRO DIAGNOSTIC
Product CodeDIP
Date Received2018-07-20
Catalog Number8298671
Lot Number2615-0166-7348
Device Expiration Date2018-07-01
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerORTHO-CLINICAL DIAGNOSTICS
Manufacturer Address100 INDIGO CREEK DRIVE ROCHESTER NY 14626 US 14626


Patients

Patient NumberTreatmentOutcomeDate
10 2018-07-20

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