ABBOTT REALTIME CMV AMPLIFICATION REAGENT 09N21-090

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2018-10-03 for ABBOTT REALTIME CMV AMPLIFICATION REAGENT 09N21-090 manufactured by Abbott Molecular, Inc..

Event Text Entries

[123517779] Complaint investigation will be performed. Note: lot, expiration, udi, manufacture date and pma number have been left blank as this mdr is being submitted on the basis that abbott realtime cmv amplification reagent (5n23-90) is similar to the abbott realtime cmv amplification reagent (09n21-090) sold in the united states. Ticket does not reference a us list 09n21-090 lot number.
Patient Sequence No: 1, Text Type: N, H10


[123517780] The abbott realtime cmv assay is an in vitro polymerase chain reaction (pcr) assay for the quantitation of cytomegalovirus (cmv) dna in human plasma or whole blood. The assay is intended for use in conjunction with clinical presentation and other laboratory markers as an indicator of initiation of therapy and for use as an aid in monitoring viral response to antiviral treatment as measured by changes in plasma or whole blood dna levels. This assay is not intended to be used as a screening test for cmv or as a diagnostic test to confirm the presence of cmv infection. Field application specialist (fas) received a call from a customer complaining of discrepant results when running realtime cmv assay whole blood protocol. When the patient was initially run a result of 899671 iu/ml (5. 95 log iu/ml) was generated. Customer reran this sample (same withdrawal) in duplicate because it was higher than expected; repeat results were 596661 iu/ml (5. 78 log iu/ml) and 55258 iu/ml (4. 74 log iu/ml). Customer requested a new withdrawal and reran the sample multiple times with the following results: (b)(6) - 18726 iu/ml (tube 1) (4. 27 log iu/ml) and 3816 iu/ml (tube 2) (3. 58 log iu/ml). (b)(6) - 2755 iu/ml (tube 1) (3. 44 log iu/ml), 2649 iu/ml (tube 1) (3. 42 log iu/ml), 3018 iu/ml (tube 2) (3. 48 log iu/ml), 16014 iu/ml (tube 2) (4. 20 log iu/ml). The results were not reported out of laboratory. There was no adverse impact to patient management reported in association with these questioned results. Although, it is unknown at this time if a malfunction has occurred. If this observation was caused by an abbott product malfunction and that malfunction were to recur, a falsely elevated result in the realtime cmv assay has the potential to cause or contribute to serious injury or death. Patient information: disease: multiple myeloma, transplanted patient. This incident is being reported to fda because the incident occurred in italy using realtime cmv assay, list number 5n23-90 which is the same/ similar to us fda approved realtime cmv list number 09n21-090.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3005248192-2018-00012
MDR Report Key7929946
Report SourceCOMPANY REPRESENTATIVE
Date Received2018-10-03
Date of Report2018-10-17
Date of Event2018-06-08
Date Mfgr Received2018-10-10
Date Added to Maude2018-10-03
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. JOE HUTSON
Manufacturer Street1300 E. TOUHY AVE.
Manufacturer CityDES PLAINES IL 600183315
Manufacturer CountryUS
Manufacturer Postal600183315
Manufacturer Phone2243617619
Manufacturer G1ABBOTT MOLECULAR, INC.
Manufacturer Street1300 E. TOUHY AVE.
Manufacturer CityDES PLAINES IL 600183315
Manufacturer CountryUS
Manufacturer Postal Code600183315
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameABBOTT REALTIME CMV AMPLIFICATION REAGENT
Generic NameCYTOMEGALOVIRUS (CMV) DNA QUANTITATIVE ASSAY
Product CodePAB
Date Received2018-10-03
Catalog Number09N21-090
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerABBOTT MOLECULAR, INC.
Manufacturer Address1300 E. TOUHY AVE. DES PLAINES IL 600183315 US 600183315


Patients

Patient NumberTreatmentOutcomeDate
10 2018-10-03

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