MAUDE Adverse Event Report: ROCHE DIAGNOSTICS ROCHE DIAGNOSTICS COBAS ELECSYS ANTI-TPO; SYSTEM, TEST, THYROID AUTOANTIBODY

Catalog Number 07026935190

Device Problem High Test Results (2457)

Patient Problem No Consequences Or Impact To Patient (2199)

Event Date 08/30/2019

Event Type  malfunction  

Manufacturer Narrative

This event occurred in (b)(6).(b)(4).

Event Description

The initial reporter complained of questionable thyroid results for 1 patient sample on a cobas 8000 e 801 module compared to competitor methods.The initial results from the customer's e 801 were reported outside of the laboratory.The competitor methods were considered correct.There were discrepant results for elecsys ft3 iii, elecsys prolactin assay, elecsys estradiol assay, elecsys testosterone ii assay from the customer's e 801 module compared the siemens centaur method.There were discrepant results for elecsys tsh assay from the customer's e 801 module compared to the siemens centaur and beckman methods.There were discrepant results for roche diagnostics cobas elecsys anti-tpo from the customer's e 801 module compared to the beckman method.There were discrepant results for elecsys dhea-s from the customer's e 801 module compared to the siemens immulite 2000 method.This medwatch will cover anti-tpo.Refer to medwatch with patient identifier (b)(6) for information on the tsh results, medwatch with patient identifier (b)(6) for information on the prolactin results, medwatch with patient identifier (b)(6) for information on the estradiol results, medwatch with patient identifier (b)(6) for information on the testosterone results, medwatch with patient identifier (b)(6) for information on the ft3 iii results, and medwatch with patient identifier (b)(6) for information on the dhea-s results.Refer to the attachment to the medwatch for all patient data.The customer's cobas e 602 module serial number was not provided.

Manufacturer Narrative

One patient sample was returned for investigation.The investigation identified an interfering factor against the streptavidin component of the reagent in the sample.The interfering factor is documented in product labeling which states: interference in the method sheets of all applicable products: in rare cases, interference due to extremely high titers of antibodies to analyte-specific antibodies, streptavidin or ruthenium can occur.These effects are minimized by suitable test design.

• Brand Name: ROCHE DIAGNOSTICS COBAS ELECSYS ANTI-TPO
• Type of Device: SYSTEM, TEST, THYROID AUTOANTIBODY
• Manufacturer (Section D): ROCHE DIAGNOSTICS; 9115 hague road; indianapolis IN 46250 0457
• MDR Report Key: 9151866
• MDR Text Key: 218206261
• Report Number: 1823260-2019-03549
• Device Sequence Number: 1
• Product Code: JZO
• Combination Product (y/n): N
• PMA/PMN Number: K051890
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: foreign,health professional,u
• Type of Report: Initial,Followup
• Report Date: 12/30/2019

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 10/03/2019
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Expiration Date: 10/31/2019
• Device Catalogue Number: 07026935190
• Device Lot Number: 39837801
• Was Device Available for Evaluation?: Yes
• Date Manufacturer Received: 09/09/2019
• Is This a Reprocessed and Reused Single-Use Device?: No
• Patient Sequence Number: 1
• Treatment: L-THYROXIN
• Patient Age: 26 YR