MULTI-DRUG 5 PANEL SCREEN TEST DOA-654

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer,health professional, report with the FDA on 2018-03-23 for MULTI-DRUG 5 PANEL SCREEN TEST DOA-654 manufactured by Alere San Diego, Inc..

Event Text Entries

[103698672] Investigation conclusion: the reported issue was not replicated in-house with retention products. Retention products were tested with in-house drug-free donor urine and all products correctly yielded negative results on all analytes at read time. The products performed as expected. Manufacturing batch record review did not uncover any abnormalities. Based on the information available, there is no indication of a product deficiency.
Patient Sequence No: 1, Text Type: N, H10


[103698673] The customer reported receiving unconfirmed false positive results for all analytes on every device from the lot number used. The unconfirmed false positive results occurred on 50 devices. No confirmation testing was performed and no treatment or intervention was provided based on the results.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2027969-2018-00032
MDR Report Key7366362
Report SourceCONSUMER,HEALTH PROFESSIONAL,
Date Received2018-03-23
Date of Report2018-03-23
Date Mfgr Received2018-03-08
Date Added to Maude2018-03-23
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactYA-LING KING
Manufacturer Street9975 SUMMERS RIDGE ROAD
Manufacturer CitySAN DIEGO CA 92121
Manufacturer CountryUS
Manufacturer Postal92121
Manufacturer Phone8588052084
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameMULTI-DRUG 5 PANEL SCREEN TEST
Generic NameENZYME IMMUNOASSAY, COCAINE AND COCAINE METABOLITES
Product CodeDIO
Date Received2018-03-23
Model NumberDOA-654
Lot NumberDOA6030463
Device Expiration Date2018-03-01
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerALERE SAN DIEGO, INC.
Manufacturer Address9975 SUMMERS RIDGE ROAD SAN DIEGO CA 92121 US 92121


Patients

Patient NumberTreatmentOutcomeDate
10 2018-03-23

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