IMMULITE 2000 030002

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2010-04-09 for IMMULITE 2000 030002 manufactured by Siemens Healthcare Diagnostics Inc..

Event Text Entries

[9888540] Siemens filed the initial mdr 2247117-2010-00015 on (b)(4) 2010. Updated (b)(4) 2012: siemens received additional information from the customer specifying that the troponin patient result reported to the physician was 21. 8 ng/ml. The sample result was obtained on (b)(4) 2010 at 15. 25. 00 h.
Patient Sequence No: 1, Text Type: N, H10


[14868882] Discordant low troponin results were obtained on one (1) patient sample. The discordant results were reported to the physician. The physician questioned the results due to the patient's history, and the sample was repeated. Patient treatment was not altered or prescribed. There was not report of adverse health consequences due to the discordant troponin results.
Patient Sequence No: 1, Text Type: D, B5


[15525131] A siemens healthcare field service engineer (fse) was sent to the customer site for instrument evaluation. Analysis of the instrument and the instrument data indicate that the cause for discordant troponin results cannot be determined. The instrument is performing within specifications. No further evaluation of the device is required.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2247117-2010-00015
MDR Report Key1656797
Report Source05,06
Date Received2010-04-09
Date of Report2010-03-15
Date of Event2010-03-10
Date Mfgr Received2010-04-12
Date Added to Maude2012-02-28
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 FDA0
Event Location0
Manufacturer ContactBARBARA KVASNOSKY
Manufacturer Street511 BENEDICT AVENUE
Manufacturer CityTARRYTOWN NY 10591
Manufacturer CountryUS
Manufacturer Postal10591
Manufacturer Phone9145243658
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS INC.
Manufacturer Street62 FLANDERS BARTLEY ROAD
Manufacturer CityFLANDERS NJ 07836
Manufacturer CountryUS
Manufacturer Postal Code07836
Single Use3
Remedial ActionOT
Previous Use Code3
Removal Correction NumberN/A
Event Type3
Type of Report3

Device Details

Brand NameIMMULITE 2000
Generic NameIMMUNO-ASSAY
Product CodeDGC
Date Received2010-04-09
Model NumberNA
Catalog Number030002
Lot NumberNA
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeNA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS INC.
Manufacturer AddressFLANDERS NJ 07835 US 07835


Patients

Patient NumberTreatmentOutcomeDate
10 2010-04-09

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