DIMENSION VISTA? UREA NITROGEN FLEX? REAGENT CARTRIDGE K1021 SMN 10445159

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,user faci report with the FDA on 2016-06-09 for DIMENSION VISTA? UREA NITROGEN FLEX? REAGENT CARTRIDGE K1021 SMN 10445159 manufactured by Siemens Healthcare Diagnostics Inc - Glasgow.

Event Text Entries

[46880387] Siemens healthcare diagnostics has determined that dimension vista? Blood urea nitrogen (bun) lots 15215ae, 15243bb, 15264ba, 15299bb, 15300ba, 15320bb, and 15341ac may exhibit inaccurate patient and/or quality control results. Only specific reagent cartridge wells are affected. If calibration is performed using an unaffected well and patient results are subsequently run using an affected well, bun results may be falsely depressed by up to approximately 50%. If calibration is performed using an affected well, bun results may be falsely elevated by up to approximately 64%. Siemens issued an urgent medical device correction dated february 2016, communication (b)(4) to all u. S accounts or an urgent field safety notice (b)(4), to all outside u. S. Accounts who had been shipped the impacted lots. Customers were directed to discard certain flexes with a specific lot number/cavity number combination. Siemens healthcare diagnostics confirmed additional complaints and has added additional blood urea nitrogen ((b)(4)) lots 16004ab, 16034aa, 16033ac, 16048aa, 16055aa, 16055ab,16062aa, 16062ab as well as all future vista bun lots until further notice to the field action. An updated information communication (b)(4) has been mailed in june 2016 to all accounts who have been shipped these lots. All new vista bun customers will receive a copy of the umdc/ufsn until affected product is depleted from inventory. The communication advised customers to follow the additional instructions under the section "actions to be taken by the customer" to manage their bun testing. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[46880388] The customer noted discrepant proficiency sample results for bun on the dimension vista(r) instrument. Sample results run on different days failed the survey ranges high or low. There was no indication if patients results were impacted there is no indication that patient treatment was altered or prescribed on the basis of discrepant bun results. There was no report of adverse health consequences as a result of discrepant bun results
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2517506-2016-00248
MDR Report Key5708613
Report SourceHEALTH PROFESSIONAL,USER FACI
Date Received2016-06-09
Date of Report2016-06-09
Date of Event2016-05-10
Date Mfgr Received2016-05-25
Device Manufacturer Date2016-02-02
Date Added to Maude2016-06-09
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 Location3
Manufacturer ContactJAMES MORGERA
Manufacturer StreetGLASGOW BUSINESS COMMUNITY PO BOX 6101
Manufacturer CityNEWARK DE 197146101
Manufacturer CountryUS
Manufacturer Postal197146101
Manufacturer Phone3026318356
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS INC - GLASGOW
Manufacturer StreetGLASGOW BUSINESS COMMUNITY 500 GBC DRIVE
Manufacturer CityNEWARK DE 19714
Manufacturer CountryUS
Manufacturer Postal Code19714
Single Use3
Remedial ActionRC
Previous Use Code3
Removal Correction NumberZ-1622-2016
Event Type3
Type of Report3

Device Details

Brand NameDIMENSION VISTA? UREA NITROGEN FLEX? REAGENT CARTRIDGE
Generic NameDIMENSION VISTA? UREA NITROGEN FLEX? REAGENT CARTRIDGE,
Product CodeCDQ
Date Received2016-06-09
Catalog NumberK1021 SMN 10445159
Lot Number16034AA
Device Expiration Date2017-02-02
OperatorMEDICAL TECHNOLOGIST
Device AvailabilityN
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS INC - GLASGOW
Manufacturer AddressGLASGOW BUSINESS COMMUNITY 500 GBC DRIVE NEWARK DE 19714 US 19714


Patients

Patient NumberTreatmentOutcomeDate
10 2016-06-09

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