HEA 1.2 BEADCHIP KIT, SLIDE 800-20202-08

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-08-10 for HEA 1.2 BEADCHIP KIT, SLIDE 800-20202-08 manufactured by Bioarray Solutions Ltd..

Event Text Entries

[117283813] Sequencing results interpretation: the sample is homozygous c. 307c, c. 676g, c. 733c and c. 1006g, and heterozygous at c. 48g>c and for the c-linked intronic marker (c. 733, c. 1006 and the intronic marker are not pictured), which is consistent with a c+c+e-e+ individual1,2. All exons for rhce were sequenced. A novel five basepair deletion in exon 5 which is proximal to the e/e antigen locus was found. This is the probable cause for the discrepancy between the hea precisetype results and serology [rhce c. 677_681delctctg][? ]. This deletion would cause an altered downstream amino acid sequence and a novel stop codon at residue 315 [p. Leu227glufs*88]. Dna-sequence variations affecting antigen expression and amino acid sequence are listed as a limitation in the precisetype hea molecular beadchip test package insert.
Patient Sequence No: 1, Text Type: N, H10


[117283814] The customer reported a possible discrepancy. The donor is c+ using the bioarray hea molecular beadchip kit; serology results were c-.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3005967741-2018-00008
MDR Report Key7773885
Date Received2018-08-10
Date of Report2018-08-10
Date of Event2018-07-10
Date Mfgr Received2018-07-10
Device Manufacturer Date2018-06-12
Date Added to Maude2018-08-10
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. LUZ VILLAMIZAR
Manufacturer Street35 TECHNOLOGY DRIVE SUITE 100
Manufacturer CityWARREN NJ 07059
Manufacturer CountryUS
Manufacturer Postal07059
Manufacturer Phone9084449591
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameHEA 1.2 BEADCHIP KIT, SLIDE
Generic NameHEA 1.2 BEADCHIP KIT, SLIDE
Product CodePEP
Date Received2018-08-10
Model Number800-20202-08
Catalog Number800-20202-08
Lot Number18-362-V
Device Expiration Date2019-05-31
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerBIOARRAY SOLUTIONS LTD.
Manufacturer Address35 TECHNOLOGY DRIVE SUITE 100 WARREN NJ 07059 US 07059


Patients

Patient NumberTreatmentOutcomeDate
10 2018-08-10

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