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.
[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
Report Number | 1823260-2018-04520 |
MDR Report Key | 8111501 |
Report Source | FOREIGN,HEALTH PROFESSIONAL,U |
Date Received | 2018-11-28 |
Date of Report | 2019-02-11 |
Date of Event | 2018-10-12 |
Date Mfgr Received | 2018-11-08 |
Date Added to Maude | 2018-11-28 |
Event Key | 0 |
Report Source Code | Manufacturer report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
Manufacturer Contact | NA MICHAEL LESLIE |
Manufacturer Street | 9115 HAGUE ROAD NA |
Manufacturer City | INDIANAPOLIS IN 46250 |
Manufacturer Country | US |
Manufacturer Postal | 46250 |
Manufacturer Phone | 3175214343 |
Manufacturer G1 | ROCHE DIAGNOSTICS GMBH |
Manufacturer Street | SANDHOFERSTRASSE 116 NA |
Manufacturer City | MANNHEIM (BADEN-WURTTEMBERG) 68305 |
Manufacturer Country | GM |
Manufacturer Postal Code | 68305 |
Single Use | 3 |
Previous Use Code | 3 |
Removal Correction Number | NA |
Event Type | 3 |
Type of Report | 3 |
Brand Name | ELECSYS RUBELLA IGG IMMUNOASSAY |
Generic Name | ENZYME LINKED IMMUNOABSORBENT ASSAY, RUBELLA |
Product Code | LFX |
Date Received | 2018-11-28 |
Model Number | NA |
Catalog Number | 07027770190 |
Lot Number | 31103600 |
Operator | HEALTH PROFESSIONAL |
Device Availability | N |
Device Age | DA |
Device Eval'ed by Mfgr | R |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | ROCHE DIAGNOSTICS |
Manufacturer Address | 9115 HAGUE ROAD NA INDIANAPOLIS IN 462500457 US 462500457 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 2018-11-28 |