VANCOMYCIN VANCOMYCIN G3

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-01-28 for VANCOMYCIN VANCOMYCIN G3 manufactured by Roche Diagnostics.

Event Text Entries

[134334097] The investigation is currently ongoing. The follow up/corrective actions are yet to be determined. No devices were returned. This device is not labeled for single use and is not reprocessed or reused.
Patient Sequence No: 1, Text Type: N, H10


[134334098] This report summarizes 1 malfunction event. Erroneous low results were generated by two cobas 4000 c (311) stand alone systems. The event involved a total of 2 patients with erroneous results for vanc3 vancomycin. The ages of the patients were requested but were not provided. The weights of the patients were requested but were not provided the genders of the patients were requested but were not provided. The races of the patients were requested but were not provided. The ethnicities of the patients were requested but were not provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1823260-2019-90004
MDR Report Key8281617
Date Received2019-01-28
Date Added to Maude2019-01-28
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional0
Initial Report to FDA0
Report to FDA3
Event Location3
Manufacturer ContactMICHAEL LESLIE
Manufacturer Street9115 HAGUE ROAD NA
Manufacturer CityINDIANAPOLIS IN 46250
Manufacturer CountryUS
Manufacturer Postal46250
Manufacturer Phone3175214343
Manufacturer G1ROCHE DIAGNOSTICS GMBH
Manufacturer StreetSANDHOFFERSTRASSE 116 NA
Manufacturer CityMANNHEIM (BADEN-WURTTEMBERG), NA 68305
Manufacturer CountryGM
Manufacturer Postal Code68305
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameVANCOMYCIN
Generic NameRADIOIMMUNOASSAY, VANCOMYCIN
Product CodeLEH
Date Received2019-01-28
Model NumberVANCOMYCIN G3
Lot Number29046601
Device Availability*
Device AgeDA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerROCHE DIAGNOSTICS
Manufacturer Address9115 HAGUE ROAD NA INDIANAPOLIS IN 46250 US 46250


Patients

Patient NumberTreatmentOutcomeDate
10 2019-01-28

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