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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ROCHE DIAGNOSTICS ELECSYS ANTI-CCP; ANTIBODIES, ANTI-CYCLIC CITRULLINATED PEPTIDE (CCP)

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ROCHE DIAGNOSTICS ELECSYS ANTI-CCP; ANTIBODIES, ANTI-CYCLIC CITRULLINATED PEPTIDE (CCP) Back to Search Results
Catalog Number 07251670190
Device Problems Incorrect, Inadequate or Imprecise Result or Readings (1535); High Test Results (2457)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 01/30/2023
Event Type  malfunction  
Event Description
The initial reporter stated they received discrepant results for two samples collected from one patient and tested with elecsys anti-ccp on a cobas 6000 e 601 module (serial number (b)(4) and a cobas e 801 analytical unit (serial number (b)(4).The sample results were reported outside of the laboratory to the patient.When the first sample was tested on the e 801 analyzer, it resulted in an anti-ccp value of 41.1 u/ml on (b)(6) 2023.This sample was repeated on the e 601 analyzer on (b)(6) 2023, resulting in a value of < 7.00 u/ml with a data flag.The second sample had similar results.On (b)(6) 2023, the second sample resulted in an anti-ccp value of 38.0 u/ml when tested on the e 801 analyzer.This sample resulted in a value of < 7.00 u/ml when tested on the e 601 analyzer.Anti-ccp reagent lot 66022801 (expiration date = 30-sep-2023) was used on the e 801 analyzer.Anti-ccp reagent lot 637426 was used on the e 601 analyzer.This reagent expiration date was requested, but not provided.
 
Manufacturer Narrative
One patient sample was provided for investigation and the customer's results could be reproduced.Na.
 
Manufacturer Narrative
The patient is healthy and participates in a lot of sports.The patient had negative results for crp and rheumatoid factor.The last calibration performed on 14-dec-2022 was within expectations.Quality controls recovered within specified ranges.Further investigations of the patient sample determined that it contains a potential interfering factor against a component of one lot of anti-ccp reagent (lot 637426), resulting in a false low anti-ccp value.Further clarification of the observed discrepancy was not possible with available methods and the current state of the art.
 
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Brand Name
ELECSYS ANTI-CCP
Type of Device
ANTIBODIES, ANTI-CYCLIC CITRULLINATED PEPTIDE (CCP)
Manufacturer (Section D)
ROCHE DIAGNOSTICS
9115 hague road
indianapolis IN 46250 0457
Manufacturer (Section G)
ROCHE DIAGNOSTICS GMBH
sandhoferstrasse 116
na
mannheim (baden-wurttemberg) 68305
GM   68305
Manufacturer Contact
amy nelson
9115 hague road
na
indianapolis, IN 46250
3174767531
MDR Report Key16498612
MDR Text Key310876585
Report Number1823260-2023-00712
Device Sequence Number1
Product Code NHX
UDI-Device Identifier04015630940370
UDI-Public04015630940370
Combination Product (y/n)N
Reporter Country CodeGM
PMA/PMN Number
K081338
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,User Facility
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 05/09/2023
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 Expiration Date09/30/2023
Device Catalogue Number07251670190
Device Lot Number66022801, 637426
Was Device Available for Evaluation? Yes
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 02/10/2023
Initial Date FDA Received03/07/2023
Supplement Dates Manufacturer Received04/28/2023
Supplement Dates FDA Received05/09/2023
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
Patient Sequence Number1
Patient Age22 YR
Patient SexFemale
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