ELECSYS PROLACTIN ASSAY PROLACTIN G2

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-04-25 for ELECSYS PROLACTIN ASSAY PROLACTIN G2 manufactured by Roche Diagnostics.

Event Text Entries

[143415193] The investigations for the 1 event did not identify a product problem. The cause of the event could not be determined. The patient sample was requested for investigation but was not provided. The follow up/corrective actions for the 1 event were as follows: the patient sample was run on a competitor system. A manual dilution was performed and the sample was checked for hemolysis. Calibration and qc were acceptable. No instrument issues were detected. The results for other patients were normal. 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


[143415194] This report summarizes 1 malfunction event. An erroneous low result was generated by the cobas 6000 e 601 module. The events involved a total of 1 patient with the following: a low prolactin result. The patient's age was (b)(6). The patient's gender was female.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1823260-2019-90089
MDR Report Key8549741
Date Received2019-04-25
Date Added to Maude2019-04-25
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 NameELECSYS PROLACTIN ASSAY
Generic NameRADIOIMMUNOASSAY, PROLACTIN (LACTOGEN)
Product CodeCFT
Date Received2019-04-25
Model NumberPROLACTIN G2
Lot Number30128002
Device Availability*
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 2019-04-25

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