COBAS B 221 SENSOR GLU/LAC/UREA 03261085184

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 2019-04-10 for COBAS B 221 SENSOR GLU/LAC/UREA 03261085184 manufactured by Roche Diagnostics.

Event Text Entries

[141482467] This event occurred in (b)(6).
Patient Sequence No: 1, Text Type: N, H10


[141482468] The initial reporter stated that they have been having ongoing issues with the glucose and lactate tests when testing patient samples using the cobas b 221 sensor glu/lac/urea on a cobas b 221 analyzer. The control performance is erratic and there is lack of result reproducibility. The field service engineer has performed extensive troubleshooting with the analyzer in order to address the issue. The customer provided data for one patient with erroneous lactate test results. The erroneous results were reported outside of the laboratory. A sample from the patient resulted with a lactate value of 4. 8 mmol/l. One hour later, a sample from this patient resulted with a lactate value of 5. 6 mmol/l. Two hours later, a sample from this patient resulted with a lactate value of 1. 6 mmol/l. The results did not fit the clinical picture of the patient as the patient was believe to still be acidotic. No adverse events were alleged to have occurred with the patient. The serial number of the cobas b 221 analyzer is (b)(4). The field service engineer moved the system to a different location and updated communication settings on the system. He replaced an electrode, the cobas b 221 sensor glu/lac/urea, a system reagent, and tubing as a precaution. He ran calibration and there were issues with the calibration. He then ran wetting maintenance routines and repeated calibration. The calibration was ok. The customer ran controls and one level was outside of range.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1823260-2019-01415
MDR Report Key8499992
Report SourceFOREIGN,HEALTH PROFESSIONAL,U
Date Received2019-04-10
Date of Report2019-10-16
Date of Event2019-03-20
Date Mfgr Received2019-03-20
Date Added to Maude2019-04-10
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 INSTRUMENT CENTER AG TEGIMENTA
Manufacturer StreetFORRENSTRASSE NA
Manufacturer CityROTKREUZ 6343
Manufacturer CountrySZ
Manufacturer Postal Code6343
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameCOBAS B 221 SENSOR GLU/LAC/UREA
Generic NameACID, LACTIC, ENZYMATIC METHOD
Product CodeKHP
Date Received2019-04-10
Model NumberNA
Catalog Number03261085184
Lot Number21590148
Device Expiration Date2019-04-19
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 2019-04-10

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