VITROS IMMUNODIAGNOSTIC PRODUCTS MYOG REAGENT PACK 6801042

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 07 report with the FDA on 2009-08-20 for VITROS IMMUNODIAGNOSTIC PRODUCTS MYOG REAGENT PACK 6801042 manufactured by Ortho-clinical Diagnostics.

Event Text Entries

[16496916] Investigation into this event found no evidence that the vitros eci did not operate as expected. The investigation determined that the samples used for the vitros myog correlation study were frozen aliquots that had been thawed three times during the timeframe of the event. The vitros myog instructions for use state: "serum samples may be stored for up to 7 days at 2-8 degrees celsius (36-46 degrees fahrenheit) or 4 weeks at -20 degrees celsius (-4 degrees fahrenheit). Avoid repeated freeze-thaw cycles of serum samples. " the definitive root cause could not be determined, however, user error in handling of the pt samples used for the correlation could not be ruled out.
Patient Sequence No: 1, Text Type: N, H10


[16704693] The ocd lab specialist reported that negatively biased vitros myog results were obtained on two pt samples processed on a vitros eci during a correlation study on (b)(6) and (b)(6) 2009. Biased results of the direction and magnitude observed could lead to inappropriate physician action. The results were not reported as they were only being used for the correlation. There was no report of pt harm as a result of this event. This report corresponds to ortho clinical diagnostics inc (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9680658-2009-00240
MDR Report Key1487553
Report Source07
Date Received2009-08-20
Date of Report2009-07-23
Date of Event2009-07-23
Date Mfgr Received2009-07-23
Device Manufacturer Date2009-01-01
Date Added to Maude2010-06-14
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationMEDICAL TECHNOLOGIST
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location0
Manufacturer ContactJOE FALVO
Manufacturer Street100 INDIGO CREEK DR.
Manufacturer CityROCHESTER NY 146265101
Manufacturer CountryUS
Manufacturer Postal146265101
Manufacturer Phone5854535735
Manufacturer G1FOREST FARM ESTATE
Manufacturer CityWHITCHURCH CARDIFF CF147YT
Manufacturer CountryUK
Manufacturer Postal CodeCF14 7YT
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameVITROS IMMUNODIAGNOSTIC PRODUCTS MYOG REAGENT PACK
Generic NameIN-VITRO DIAGNOSTIC
Product CodeDDR
Date Received2009-08-20
Model NumberNA
Catalog Number6801042
Lot Number0590
ID NumberNA
Device Expiration Date2009-11-02
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerORTHO-CLINICAL DIAGNOSTICS
Manufacturer Address100 INDIGO CREEK DR. ROCHESTER NY 14626510 US 14626 5101


Patients

Patient NumberTreatmentOutcomeDate
10 2009-08-20

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