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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: QUIDELORTHO CORPORATION CVS HEALTH AT HOME COVID-19 TEST KIT

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QUIDELORTHO CORPORATION CVS HEALTH AT HOME COVID-19 TEST KIT Back to Search Results
Catalog Number 20452
Device Problems False Negative Result (1225); No Apparent Adverse Event (3189)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 01/10/2024
Event Type  malfunction  
Event Description
Customer reporting 2 potential false negative sars results.Customer states they were negative by cvs at-home test and the next day was positive by another brand rapid antigen test.The customer states they were negative by cvs at-home test again when testing 5 days after the positive result.No testing was done in between positive and negative test and no confirmation testing was performed.Report 2 of 2.
 
Manufacturer Narrative
Investigation conclusion: a review of the product did not find any unusual trend for the reported complaint category.Root cause: unable to determine.Source: phone.
 
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Brand Name
CVS HEALTH AT HOME COVID-19 TEST KIT
Type of Device
CVS HEALTH AT HOME COVID-19 TEST KIT
Manufacturer (Section D)
QUIDELORTHO CORPORATION
10165 mckellar court
san diego CA 92121
Manufacturer Contact
karl luke
10165 mckellar court
san diego, CA 92121
MDR Report Key18705149
MDR Text Key335442078
Report Number0002024674-2024-00151
Device Sequence Number1
Product Code QKP
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
EUA210269/S4
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Consumer
Reporter Occupation Other
Type of Report Initial
Report Date 02/14/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/14/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Lay User/Patient
Device Catalogue Number20452
Device Lot Number2310008
Date Manufacturer Received01/16/2024
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Patient Sequence Number1
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