ELECSYS RUBELLA IGG IMMUNOASSAY 07027770190

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional,u report with the FDA on 2018-11-28 for ELECSYS RUBELLA IGG IMMUNOASSAY 07027770190 manufactured by Roche Diagnostics.

Event Text Entries

[129195797] This event occurred in (b)(6).
Patient Sequence No: 1, Text Type: N, H10


[129195798] The customer received questionable elecsys rubella igg immunoassay results for one patient from cobas e 801 module serial number (b)(4). The rubella igm result was 7. 67 (positive) and the rubella igg result was 8. 15 u/ml (negative). The customer suspected acute infection. The sample was repeated and the same results were received. The rubella pcr from a throat swab was negative. The customer sent an aliquot of the same sample to the reference laboratory. The igg result was 31 u/ml (positive) and the igm result was negative which indicated an immunized patient. The results were reported outside of the laboratory. There was no allegation of an adverse event.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1823260-2018-04520
MDR Report Key8111501
Report SourceFOREIGN,HEALTH PROFESSIONAL,U
Date Received2018-11-28
Date of Report2019-02-11
Date of Event2018-10-12
Date Mfgr Received2018-11-08
Date Added to Maude2018-11-28
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 ContactNA MICHAEL LESLIE
Manufacturer Street9115 HAGUE ROAD NA
Manufacturer CityINDIANAPOLIS IN 46250
Manufacturer CountryUS
Manufacturer Postal46250
Manufacturer Phone3175214343
Manufacturer G1ROCHE DIAGNOSTICS GMBH
Manufacturer StreetSANDHOFERSTRASSE 116 NA
Manufacturer CityMANNHEIM (BADEN-WURTTEMBERG) 68305
Manufacturer CountryGM
Manufacturer Postal Code68305
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameELECSYS RUBELLA IGG IMMUNOASSAY
Generic NameENZYME LINKED IMMUNOABSORBENT ASSAY, RUBELLA
Product CodeLFX
Date Received2018-11-28
Model NumberNA
Catalog Number07027770190
Lot Number31103600
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerROCHE DIAGNOSTICS
Manufacturer Address9115 HAGUE ROAD NA INDIANAPOLIS IN 462500457 US 462500457


Patients

Patient NumberTreatmentOutcomeDate
10 2018-11-28

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