COBAS 6000 C (501) MODULE C501 04745914001

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 2017-08-07 for COBAS 6000 C (501) MODULE C501 04745914001 manufactured by Roche Diagnostics.

Event Text Entries

[82722879] Unique identifier (udi)#: (b)(4). This event occurred in (b)(6).
Patient Sequence No: 1, Text Type: N, H10


[82722880] The customer obtained questionable high test results for three patient samples using the trigl triglycerides (trigl) assay on the cobas 6000 c (501) module. Result data was provided for one patient sample. The initial result was released outside of the laboratory to the doctor. All results are in units of mg/dl. The initial result was 220; the repeat result on a different module was 118. There was no allegation that an adverse event occurred. The trigl reagent lot number is 22259201 with an expiration date of 02/28/2018. The customer changed the cuvettes and the photometer lamp "last week" and changes them regularly. Calibration and quality controls were acceptable; therefore, a general reagent issue could be excluded. The reaction monitor data was abnormal for both results. The alarm log indicated an abnormal probe sucking alarm which was possibly related to the initial result. The customer performed a precision check on (b)(6) 2017. The cell rinse functionality for trigl was acceptable. The field service representative (fsr) stated that the customer has had a few pre-analytical issues. Some of the samples come from external clinics and sample quality is poor. The fsr adjusted up the gear pump pressure which was very low; performed a cell detergent prime; and changed the teflon tips of the washing station. He confirmed that all necessary special wash programs were installed. He checked the detergent consumption and water quality which were acceptable. He took water samples and sent them for microbial analysis. The customer has not had further issues since the service activities. Investigation activities are ongoing.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1823260-2017-01625
MDR Report Key6770489
Report SourceFOREIGN,HEALTH PROFESSIONAL,U
Date Received2017-08-07
Date of Report2017-08-25
Date of Event2017-07-17
Date Mfgr Received2017-07-17
Date Added to Maude2017-08-07
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 ContactNA MICHAEL LESLIE
Manufacturer Street9115 HAGUE ROAD NA
Manufacturer CityINDIANAPOLIS IN 46250
Manufacturer CountryUS
Manufacturer Postal46250
Manufacturer Phone3175214343
Manufacturer G1HITACHI HIGH TECH CORP.
Manufacturer Street882 ICHIGE HITACHINAKA NA
Manufacturer CityIBARAKI 312-8504
Manufacturer CountryJA
Manufacturer Postal Code312-8504
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Sequence Number: 0

Brand NameCOBAS 6000 C (501) MODULE
Generic NameCLINICAL CHEMISTRY ANALYZER
Product CodeJGY
Date Received2017-08-07
Model NumberC501
Catalog Number04745914001
Lot NumberNA
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No0
Device Event Key0
ManufacturerROCHE DIAGNOSTICS
Manufacturer Address9115 HAGUE ROAD NA INDIANAPOLIS IN 462500457 US 462500457

Device Sequence Number: 1

Brand NameCOBAS 6000 C (501) MODULE
Generic NameCLINICAL CHEMISTRY ANALYZER
Product CodeJJE
Date Received2017-08-07
Model NumberC501
Catalog Number04745914001
Lot NumberNA
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerROCHE DIAGNOSTICS
Manufacturer Address9115 HAGUE ROAD NA INDIANAPOLIS IN 462500457 US 462500457


Patients

Patient NumberTreatmentOutcomeDate
10 2017-08-07

© 2024 FDA.report
This site is not affiliated with or endorsed by the FDA.