VITROS IMMUNODIAGNOSTIC PRODUCTS MYOGLOBIN REAGENT PACK 6801042

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-05-24 for VITROS IMMUNODIAGNOSTIC PRODUCTS MYOGLOBIN REAGENT PACK 6801042 manufactured by Ortho-clinical Diagnostics.

Event Text Entries

[76054065] The investigation determined that lower than expected myog quality control results were obtained using a non-vitros quality control fluid in combination with a vitros 5600 integrated system. A definitive assignable cause was not determined. The most likely assignable cause for the lower than expected myog results is an issue with a non-vitros bio rad qc fluid. There is no indication that the vitros 5600 integrated system or the vitros myog reagent malfunctioned.
Patient Sequence No: 1, Text Type: N, H10


[76054066] The customer observed lower than expected vitros myog results obtained from non-vitros bio rad quality control fluids processed on a vitros 5600 integrated system. Vitros myog results of 106. 8, 108. 4 and 106. 997 ng/ml versus the peer group mean of 121. 7 ng/ml. A biased result of the direction and magnitude observed may lead to inappropriate physician action if it were to occur undetected with patient samples. Ortho has not been made aware of any erroneous vitros myog patient results obtained or reported from the laboratory over the time frame of the event, however, the investigation cannot conclude that patient sample results were not affected or would not be affected if the event were to recur undetected. There was no reported allegation of patient harm as a result of this event. (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3007111389-2017-00065
MDR Report Key6587573
Date Received2017-05-24
Date of Report2017-09-19
Date of Event2017-04-26
Date Mfgr Received2017-04-26
Device Manufacturer Date2017-01-04
Date Added to Maude2017-05-24
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
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 StreetFELINDRE MEADOWS PENCOED
Manufacturer CityBRIDGEND, WALES CF355PZ
Manufacturer CountryUK
Manufacturer Postal CodeCF35 5PZ
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameVITROS IMMUNODIAGNOSTIC PRODUCTS MYOGLOBIN REAGENT PACK
Generic NameIN VITRO DIAGNOSTICS
Product CodeDDR
Date Received2017-05-24
Catalog Number6801042
ID Number10758750001019
Device Expiration Date2017-11-13
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
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 2017-05-24

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