VITROS CHEMISTRY PRODUCTS LAC SLIDES 8433880

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-11-17 for VITROS CHEMISTRY PRODUCTS LAC SLIDES 8433880 manufactured by Ortho-clinical Diagnostics.

Event Text Entries

[60752581] The investigation determined that higher and lower than expected vitros lac quality control results were obtained from vitros control fluids using two different lots of vitros lac slides on a vitros 350 chemistry system. A definitive assignable cause could not be determined. There is no evidence that a vitros 350 system occurred. The unacceptable historical vitros lac quality control results obtained from the customer indicate that the vitros lac lot 3530-0092-3271 was not performing as intended. However, it is suspected that the customer is not following correct protocol when reconstituting the calibrator and control fluids but could not be confirmed.
Patient Sequence No: 1, Text Type: N, H10


[60752582] The customer observed higher and lower than expected vitros lac quality control results from vitros control fluids using two different lots of vitros lac slides on a vitros 350 chemistry system. Vitros lac lot 3530-0092-3271: pv2 lot k4852 vitros lac result 2. 58*, 2. 64*, 2. 61*, 2. 62*, 2. 37*, 2. 58*, 2. 60*, 2. 59*, 2. 60*, 2. 56*, 2. 64*, 2. 62*, 2. 58*, 2. 60*, and 2. 61* mmol/l ,versus the expected vitros lac result 3. 96 mmol/l; pv2 lot m5007 vitros lac results 5. 09*, 2. 54* and 5. 19* mmol/l versus the expected vitros lac result 3. 76 mmol/l. Vitros lac lot 3531-0093-5063: pv1 lot l5005 vitros lac result 2. 13* mmol/l versus the expected vitros lac result 1. 39 mmol/l; pv2 lot m5007 vitros lac result 5. 67* mmol/l versus the expected vitros lac result 3. 33 mmol/l. Biased results of the direction and magnitude observed may lead to inappropriate physician action. Although there were no reports of affected patient sample results, it cannot be confirmed that patient sample results were not affected and would not be affected if the event were to recur undetected. There were no allegations of patient harm. This report is number four of twenty mdr's for this event. Twenty 3500a forms are being submitted for this event as twenty devices were involved. (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1319809-2016-00097
MDR Report Key6110944
Date Received2016-11-17
Date of Report2016-11-17
Date of Event2016-10-25
Date Mfgr Received2016-10-26
Device Manufacturer Date2016-06-16
Date Added to Maude2016-11-17
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 ContactMR. JAMES A STEVENS
Manufacturer Street100 INDIGO CREEK DRIVE
Manufacturer CityROCHESTER NY 14626
Manufacturer CountryUS
Manufacturer Postal14626
Manufacturer Phone5854533000
Manufacturer G1ORTHO-CLINICAL DIAGNOSTICS
Manufacturer Street513 TECHNOLOGY BLVD.
Manufacturer CityROCHESTER NY 14652
Manufacturer CountryUS
Manufacturer Postal Code14652
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameVITROS CHEMISTRY PRODUCTS LAC SLIDES
Generic NameIN VITRO DIAGNOSTIC
Product CodeKHP
Date Received2016-11-17
Catalog Number8433880
Lot Number3530-0092-3271
Device Expiration Date2017-12-01
OperatorMEDICAL TECHNOLOGIST
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerORTHO-CLINICAL DIAGNOSTICS
Manufacturer Address100 INDIGO CREEK DRIVE ROCHESTER NY 14626 US 14626


Patients

Patient NumberTreatmentOutcomeDate
10 2016-11-17

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