ROCHE CARDIAC D-DIMER 04877802190

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional,u report with the FDA on 2019-02-07 for ROCHE CARDIAC D-DIMER 04877802190 manufactured by Roche Diagnostics.

Event Text Entries

[135504623] This event occurred in (b)(6).
Patient Sequence No: 1, Text Type: N, H10


[135504624] The customer stated that they received questionable results for 5 patient samples tested with roche cardiac d-dimer and roche cardiac probnp+ on a cobas h 232 analyzer. Of the 5 samples, two had erroneous d-dimer results. The cobas h 232 analyzer is not released for distribution in the united states, nor is it like or similar to a product released for distribution in the united states. The first sample initially resulted with a d-dimer value of 2. 13 ug/ml when tested on the customer's cobas h 232 analyzer. The sample was sent to another laboratory for testing with an unknown method, resulting with a d-dimer value of 3. 65 ug/ml. The second sample initially resulted with a d-dimer value of 0. 52 ug/ml when tested on the customer's cobas h 232 analyzer. The sample was sent to another laboratory for testing with an unknown method, resulting with a d-dimer value of 0. 76 ug/ml. No adverse events were alleged to have occurred with the patients. The cobas h 232 analyzer serial number is (b)(4). Controls were tested on the analyzer and these passed.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1823260-2019-00505
MDR Report Key8316348
Report SourceFOREIGN,HEALTH PROFESSIONAL,U
Date Received2019-02-07
Date of Report2019-08-19
Date of Event2019-01-23
Date Mfgr Received2019-01-23
Date Added to Maude2019-02-07
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 FDA3
Event Location3
Manufacturer ContactNA MICHAEL LESLIE
Manufacturer Street9115 HAGUE ROAD NA
Manufacturer CityINDIANAPOLIS IN 46250
Manufacturer CountryUS
Manufacturer Postal46250
Manufacturer Phone3175214343
Manufacturer G1ROCHE DIAGNOSTICS GMBH
Manufacturer StreetSANDHOFERSTRASSE 116 NA
Manufacturer CityMANNHEIM (BADEN-WURTTEMBERG) 68305
Manufacturer CountryGM
Manufacturer Postal Code68305
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameROCHE CARDIAC D-DIMER
Generic NameFIBRINOGEN AND FIBRIN SPLIT PRODUCTS
Product CodeGHH
Date Received2019-02-07
Model NumberNA
Catalog Number04877802190
Lot NumberASKU
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerROCHE DIAGNOSTICS
Manufacturer Address9115 HAGUE ROAD NA INDIANAPOLIS IN 462500457 US 462500457


Patients

Patient NumberTreatmentOutcomeDate
10 2019-02-07

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