DIMENSION? DF207 SMN10700795

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 2019-01-16 for DIMENSION? DF207 SMN10700795 manufactured by Siemens Healthcare Diagnostics Inc.

Event Text Entries

[133358624] Mdrs 2517506-2019-00021 and 2517506-2019-00022 were also filed for the same event. The customer contacted the siemens customer care center (ccc) and reported a discordant, falsely elevated tacrolimus (tac) patient result obtained on the dimension rxl system. Siemens is investigating the event.
Patient Sequence No: 1, Text Type: N, H10


[133358645] A discordant elevated tacrolimus (tac) result was obtained (b)(6) 2018 on a patient sample on a dimension rxl instrument. The same sample was reprocessed on an alternate dimension rxl instrument and a similarly elevated tac result was obtained. A sample from the same patient had been processed with an alternate methodology and a lower result was obtained which was considered correct by the physician. There are no known reports of patient intervention or adverse health consequences due to the discordant elevated tac result.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2517506-2019-00023
MDR Report Key8254247
Report SourceFOREIGN,HEALTH PROFESSIONAL,U
Date Received2019-01-16
Date of Report2019-03-11
Date of Event2018-12-27
Date Mfgr Received2019-02-21
Device Manufacturer Date2018-04-20
Date Added to Maude2019-01-16
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 ContactJAMES MORGERA
Manufacturer Street500 GBC DRIVE P.O. BOS 6101
Manufacturer CityNEWARK DE 197146101
Manufacturer CountryUS
Manufacturer Postal197146101
Manufacturer Phone3026318356
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS INC
Manufacturer Street500 GBC DRIVE P.O. BOS 6101
Manufacturer CityNEWARK DE 197146101
Manufacturer CountryUS
Manufacturer Postal Code197146101
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameDIMENSION?
Generic NameDIMENSION? TACROLIMUS FLEX? REAGENT CARTRIDGE
Product CodeMLM
Date Received2019-01-16
Catalog NumberDF207 SMN10700795
Lot NumberGA9106
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS INC
Manufacturer Address500 GBC DRIVE P.O. BOS 6101 NEWARK DE 197146101 US 197146101


Patients

Patient NumberTreatmentOutcomeDate
10 2019-01-16

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