HEMOCHRON SIGNATURE ELITE

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2018-11-28 for HEMOCHRON SIGNATURE ELITE manufactured by Accriva Diagnostics.

Event Text Entries

[129461064] This mdr references accriva diagnostics' complaint number (b)(4) for the hemochron signature elite instrument, serial number (b)(4). Complaint number (b)(4) captures the child case for the lot number of the jact+ cuvette used during the procedure. Method: testing of actual/suspected device. Analysis of production records. Results: no device problem found. Analysis of production records did not show a history of repairs, non-conformities, capa, or other related complaints. Conclusion: no problem detected. Accriva diagnostics has requested all data required for form 3500a. This report serves as the initial and final mdr for this case and effectively closes the complaint.
Patient Sequence No: 1, Text Type: N, H10


[129461065] A healthcare professional reported inconsistent act results when 2 hemochron signature elite and act+ whole blood microcoagulation systems were run side-by-side during open heart surgery. The target act for this procedure was >420 seconds. After an intravenous bolus dose of heparin was given, the first 2 act readings with the elite named in this complaint were below the act target and were lower than expected. The act readings for the same 2 blood samples tested on a second hemochron signature elite and act+ microcoagulation system were 517 and 570 seconds, respectively. These results were above the target act and were used for patient management. The procedure was completed successfully and no adverse events were reported. Both electronic and liquid quality controls passed on both elite systems prior to the procedure.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2250033-2018-00026
MDR Report Key8113818
Report SourceHEALTH PROFESSIONAL
Date Received2018-11-28
Date of Report2018-10-31
Date of Event2018-10-29
Date Mfgr Received2018-10-31
Device Manufacturer Date2011-03-01
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 ContactJON MCDERMED
Manufacturer Street6260 SEQUENCE DRIVE
Manufacturer CitySAN DIEGO CA 92121
Manufacturer CountryUS
Manufacturer Postal92121
Manufacturer Phone8582632490
Manufacturer G1ACCRIVA DIAGNOSTICS
Manufacturer Street6260 SEQUENCE DRIVE
Manufacturer CitySAN DIEGO CA 92121
Manufacturer CountryUS
Manufacturer Postal Code92121
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameHEMOCHRON SIGNATURE ELITE
Generic NameSYSTEM, MULTIPURPOSE FOR IN VITRO COAGULATION STUDIES
Product CodeJPA
Date Received2018-11-28
Returned To Mfg2018-11-14
Model NumberELITE
Catalog NumberELITE
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerACCRIVA DIAGNOSTICS
Manufacturer Address6260 SEQUENCE DRIVE SAN DIEGO CA 92121 US 92121


Patients

Patient NumberTreatmentOutcomeDate
10 2018-11-28

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