MAUDE Adverse Event Report: IMMUCOR, INC. GALILEO ECHO; AUTOMATED BLOOD BANK SYSTEM

Catalog Number 0087000

Device Problem False Positive Result (1227)

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

Event Date 11/28/2018

Event Type  malfunction  

Manufacturer Narrative

Immucor technical support used a remote electronic connection method on 29nov2018 to assess the instrument test wells in question, which appeared as the final test well images being shown between where the rh (d) test well images should have been.The camera report was optimal and there were no errors at the times of testing.Immucor technical support advised the customer site to powercycle the instrument when this scenario happens.The immucor internal report record number for this report is (b)(4).

Event Description

On (b)(6) 2018, a customer site reported that the final test well images of an rh (d) blood type testing showed being split between rh (d) test well images on a galileo echo instrument, which led to an rh (d) mistype event, when tested on (b)(6) 2018.Two (2) blood samples were reported, however the way that the demographic information was provided, there is no clear indication of which piece of demographic information correctly goes with another piece of demographic information.Consequently this is one (1) report.

• Brand Name: GALILEO ECHO
• Type of Device: AUTOMATED BLOOD BANK SYSTEM
• Manufacturer (Section D): IMMUCOR, INC.; 3130 gateway drive; norcross GA 30091 5625
• Manufacturer (Section G): IMMUCOR, INC.; 3130 gateway drive; norcross GA 30091 5625
• Manufacturer Contact: howard yorek ; 3130 gateway drive; norcross, GA 30091-5625 ; 7704412051
• MDR Report Key: 8184746
• MDR Text Key: 131334899
• Report Number: 1034569-2018-00282
• Device Sequence Number: 1
• Product Code: KSZ
• UDI-Device Identifier: 10888234001584
• UDI-Public: 10888234001584
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: BK170132
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: health professional,user faci
• Reporter Occupation: Other Health Care Professional
• Type of Report: Initial
• Report Date: 12/20/2018

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: No Information
• Device Catalogue Number: 0087000
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: Yes
• Initial Date Manufacturer Received: 11/29/2018
• Initial Date FDA Received: 12/20/2018
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 08/30/2007
• Is the Device Single Use?: No
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Unknown
• Patient Sequence Number: 1
• Patient Age: 85 YR