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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BIOARRAY SOLUTIONS, LIMITED PRECISETYPE HEA MOLECULAR BEADCHIP TEST KIT; MOLECULIAR ERYTHROCYTE TYPING TEST

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BIOARRAY SOLUTIONS, LIMITED PRECISETYPE HEA MOLECULAR BEADCHIP TEST KIT; MOLECULIAR ERYTHROCYTE TYPING TEST Back to Search Results
Model Number 800-20202-96
Device Problem False Negative Result (1225)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 10/03/2022
Event Type  malfunction  
Manufacturer Narrative
Customer reported a possible discrepancy as a sample typed fya- and upon retest, the same sample resulted in fya+.Update 01aug2023: the nature of the health hazard is considered medium since multiple false-negative results have been confirmed.The risk could be mitigated if the customer is aware of the discrepant results and can rerun the samples on another carrier.In addition, these flipped calls occurred on donor samples, and there is no risk to the donor.Any recipient would be typed and cross-matched to the donor.
 
Event Description
Multiple false negative calls on fya.Possible discrepancy as a sample typed fya- and upon retest, the same sample resulted in fya+.Update as of 01aug2023: trending analysis determined this is the only complaint for this lot 22-117-v of this complaint nature, however the second instance of the customer reporting false fya(0) results within the past year.The false fya(0) results are caused by the significant change in the fya/fyb delta values for samples that should result as fya(+) and is due to the reduced reactivity of the fya beads relative to the fyb beads of the beadchips.The underlying root cause of the reduced reactivity is unknown at this time.
 
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Brand Name
PRECISETYPE HEA MOLECULAR BEADCHIP TEST KIT
Type of Device
MOLECULIAR ERYTHROCYTE TYPING TEST
Manufacturer (Section D)
BIOARRAY SOLUTIONS, LIMITED
35 technology drive
suite#100
warren NJ 07059
Manufacturer (Section G)
BIOARRAY SOLUTIONS, LTD.
35 technology drive
suite# 100
warren NJ 07059
Manufacturer Contact
jesdeep sidhu
35 technology drive
suite# 100
warren, NJ 07059
9084449591
MDR Report Key17435683
MDR Text Key320162650
Report Number3005967741-2022-00003
Device Sequence Number1
Product Code PEP
UDI-Device Identifier10888234102618
UDI-Public10888234102618
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
BP130026
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type User Facility
Reporter Occupation Other
Type of Report Initial
Report Date 08/01/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received08/01/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date12/31/2023
Device Model Number800-20202-96
Device Catalogue Number800-20202-96
Device Lot Number22-117-V
Was Device Available for Evaluation? No
Date Manufacturer Received09/29/2022
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured08/19/2022
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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