ARCHITECT IVANCOMYCIN 01P30-29

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional report with the FDA on 2019-05-21 for ARCHITECT IVANCOMYCIN 01P30-29 manufactured by Abbott Germany.

Event Text Entries

[145662806] All patient information has been included. No additional patient information is available. This report is being filed for an international product (list: 01p30-27), that has a similar product distributed in the us (list: 1p30-28). An evaluation is in process. A follow-up report will be submitted when the evaluation is complete.
Patient Sequence No: 1, Text Type: N, H10


[145662807] The customer reported false decreased vancomycin results for a male patient when processing on the architect i1000sr. The following data was provided: sid: (b)(4): initial 1. 55 ug/ml (low) and repeat 18. 46ug/ml (high). Sid: (b)(4) results were corrected before any clinical decisions were made. No additional patient details were provided. No impact to patient management was reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3002809144-2019-00295
MDR Report Key8628046
Report SourceFOREIGN,HEALTH PROFESSIONAL
Date Received2019-05-21
Date of Report2019-09-18
Date of Event2019-05-01
Date Mfgr Received2019-08-19
Date Added to Maude2019-05-21
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 ContactCHRISTIAN LEE
Manufacturer Street100 ABBOTT PARK ROAD DEPT 09B9, BLDG CP01-3
Manufacturer CityABBOTT PARK IL 600643537
Manufacturer CountryUS
Manufacturer Postal600643537
Manufacturer Phone224668-294
Manufacturer G1ABBOTT GERMANY
Manufacturer StreetMAX-PLANCK-RING 2
Manufacturer CityWIESBADEN 65205
Manufacturer CountryGM
Manufacturer Postal Code65205
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameARCHITECT IVANCOMYCIN
Generic NameVANCOMYCIN
Product CodeLEH
Date Received2019-05-21
Catalog Number01P30-29
Lot Number07219A000
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerABBOTT GERMANY
Manufacturer AddressMAX-PLANCK-RING 2 WIESBADEN 65205 GM 65205


Patients

Patient NumberTreatmentOutcomeDate
10 2019-05-21

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