DIMENSION VISTA 500

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,user faci report with the FDA on 2017-04-13 for DIMENSION VISTA 500 manufactured by Siemens Healthcare Diagnostics Inc..

Event Text Entries

[72885265] The customer contacted a siemens customer care center (ccc) specialist. The ccc specialist determined that the customer had replaced the filter of the water purification module (wpm) prior to the event occurrence. The customer calibrated the assay suspecting that the water may have caused the problem. The ccc specialist dialed into the system remotely and ensured that the filters were installed properly. The ccc specialist then emptied and refilled wpm to ensure that there was no contamination. Upon the ccc specialist's instructions, the customer recalibrated the assay and the results were acceptable. The ccc specialist reviewed the calibration data and verified that the signal readings were within specifications post recalibration. Quality controls were within acceptable ranges. The ccc specialist stated that the issue occurred when the customer replaced the filter on the wpm without thoroughly rinsing it. The filters contain glycerol, which caused the water in the system to become contaminated with glycerol, resulting in elevated trig results. The ccc also stated the recalibration of the assay by the customer on the suspicion that the water may have caused the problem further contributed to the issue. Emptying and refilling the wpm and then recalibrating the assay after refilling the water resolved the issue. The instrument is performing according to specifications. No further evaluation of the device is required.
Patient Sequence No: 1, Text Type: N, H10


[72885266] Discordant, falsely elevated triglyceride (trig) results were obtained on multiple patient samples on a dimension vista 500 instrument. The samples were repeated on the same instrument, resulting lower than the initial results however, still elevated. The discordant results were not reported to the physician(s), except for one patient sample. The samples were repeated on an alternate dimension vista instrument, resulting different from the results obtained on the original dimension vista instrument (s/n: (b)(4)) and matching the clinical picture of the patients. The results obtained on the alternate dimension vista were reported to the physician(s). There are no reports of patient intervention or adverse health consequence due to the discordant, falsely elevated trig results.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2517506-2017-00390
MDR Report Key6490460
Report SourceHEALTH PROFESSIONAL,USER FACI
Date Received2017-04-13
Date of Report2017-04-13
Date of Event2017-03-20
Date Mfgr Received2017-03-20
Device Manufacturer Date2013-02-06
Date Added to Maude2017-04-13
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactCASSANDRA KOCSIS
Manufacturer Street511 BENEDICT AVE
Manufacturer CityTARRYTOWN NY 10591
Manufacturer CountryUS
Manufacturer Postal10591
Manufacturer Phone9145242687
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS INC
Manufacturer StreetREGISTRATION #: 1226181 101 SILVERMINE ROAD
Manufacturer CityBROOKFIELD CT 06804
Manufacturer CountryUS
Manufacturer Postal Code06804
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Sequence Number: 0

Brand NameDIMENSION VISTA 500
Generic NameCLINICAL CHEMISTRY ANALYZER
Product CodeJGY
Date Received2017-04-13
Model NumberDIMENSION VISTA 500
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No0
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS INC.
Manufacturer Address500 GBC DRIVE PO BOX 6101 NEWARK DE 197146101 US 197146101

Device Sequence Number: 1

Brand NameDIMENSION VISTA 500
Generic NameCLINICAL CHEMISTRY ANALYZER
Product CodeJJE
Date Received2017-04-13
Model NumberDIMENSION VISTA 500
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS INC.
Manufacturer Address500 GBC DRIVE PO BOX 6101 NEWARK DE 197146101 US 197146101


Patients

Patient NumberTreatmentOutcomeDate
10 2017-04-13

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