MAUDE Adverse Event Report: ROCHE DIAGNOSTICS FT4, FREE THYROXINE; RADIOIMMUNOASSAY, FREE THYROXINE

Catalog Number 06437281190

Device Problem High Test Results (2457)

Patient Problem No Known Impact Or Consequence To Patient (2692)

Event Date 07/17/2015

Event Type  malfunction  

Manufacturer Narrative

This event occurred in (b)(6).

Event Description

The customer received a questionable free thyroxine (ft4) result for one patient sample from a cobas e602 analyzer.The specific date of testing was not provided.The sample was submitted for investigation and tested on a cobas 8000 e602, cobas e411 and a siemens centaur analyzer on (b)(6) 2015.Customer's result: 2.61 and 2.65 ng/ml.Centaur: 2.1 ng/ml.Cobas 8000 e602: 2.54 ng/ml.Cobas e411: 2.55 ng/ml.Information concerning which result was reported outside the laboratory was requested, but was not provided.No adverse event was reported.A specific root cause could not be identified.Additional information for further investigation was requested but was not provided.With the information provided, a general reagent issue could be excluded.As insufficient sample volume was available, no further investigation could be performed.Differences in the results between methods could be due to the different setups of the assays, the antibodies used and the variances in reference methods.The results for all thyroid parameters vary with age and gender of the patient and other population characteristics.These factors should be taken into account when analyzing the results.

• Brand Name: FT4, FREE THYROXINE
• Type of Device: RADIOIMMUNOASSAY, FREE THYROXINE
• Manufacturer (Section D): ROCHE DIAGNOSTICS; 9115 hague road; indianapolis IN 46250
• Manufacturer (Section G): ROCHE DIAGNOSTICS GMBH; sandhoferstrasse 116; na; mannheim (baden-wurttemberg) 68305 ; GM 68305
• Manufacturer Contact: michael leslie ; 9115 hague road; na; indianapolis, IN 46250 ; 3175214343
• MDR Report Key: 4996697
• MDR Text Key: 22841347
• Report Number: 1823260-2015-03939
• Device Sequence Number: 1
• Product Code: CEC
• Combination Product (y/n): N
• Reporter Country Code: JA
• PMA/PMN Number: K961489
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: foreign,health professional,u
• Reporter Occupation: Health Professional
• Report Date: 08/06/2015

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Catalogue Number: 06437281190
• Device Lot Number: ASKU
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: Yes
• Event Location: Laboratory
• Initial Date Manufacturer Received: Not provided
• Initial Date FDA Received: 08/12/2015
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Is the Device Single Use?: No
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: N
• Patient Sequence Number: 1