ACCESS? HLH REAGENT 33510

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 2011-06-07 for ACCESS? HLH REAGENT 33510 manufactured by Beckman Coulter, Inc..

Event Text Entries

[2007285] The customer contacted beckman coulter, inc (bci) to report erroneous "no value" results for luteinizing hormone (lh) for four patient samples assayed using the access hlh reagent on an access 2 immunoassay system. The patient results were not reported out of the laboratory. There was no reported patient impact. The customer reported that quality controls were assayed earlier in the day prior to assaying the patient samples. All quality control results were within their respective ranges. The customer subsequently inserted a freshly opened hlh reagent pack onto the access 2 immunoassay system and re-assayed the four patient samples. Numerical results were obtained for each of the patient samples and all quality control results were within their respective ranges. A definitive root cause for this event has not yet been determined.
Patient Sequence No: 1, Text Type: D, B5


[9128565] Method: evaluation and troubleshooting activities were conducted via telephone. Result: erroneous data generated. Conclusion: a definitive root cause for the event has not been determined.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2122870-2011-01649
MDR Report Key2115518
Report Source06
Date Received2011-06-07
Date of Report2011-05-11
Date of Event2011-05-11
Date Mfgr Received2011-05-11
Date Added to Maude2011-09-19
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional0
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactMS. NORA ZEROUNIAN
Manufacturer Street250 S. KRAEMER BLVD.
Manufacturer CityBREA CA 92821
Manufacturer CountryUS
Manufacturer Postal92821
Manufacturer Phone7149613634
Manufacturer G1BECKMAN COULTER, INC.
Manufacturer Street1000 LAKE HAZELTINE DRIVE
Manufacturer CityCHASKA MN 55318
Manufacturer CountryUS
Manufacturer Postal Code55318
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameACCESS? HLH REAGENT
Generic NameHUMAN LUTEINIZING HORMONE ASSAY
Product CodeCEP
Date Received2011-06-07
Catalog Number33510
Lot Number021773
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerBECKMAN COULTER, INC.
Manufacturer Address1000 LAKE HAZELTINE DRIVE CHASKA MN 55318 US 55318


Patients

Patient NumberTreatmentOutcomeDate
10 2011-06-07

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