The sample from (b)(6) 2019 was sent to an external laboratory and tested by the siemens method with a total psa result of 3.15 ng/ml and a free psa result of 0.10 ng/ml.The sample from (b)(6) 2019 was tested at the investigation site on an e801 module and the customer's observation was reproduced.The sample from (b)(6) 2019 underwent interference testing where there was strong evidence for the presence of endogenous interfering substances that would considerably decrease the total psa results.Additional interference testing suggests the presence of a rare psa-isoform that cannot be completely detected by the standard total psa assay.These issues are addressed in product labeling: "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." "it is known that in rare cases psa isoforms do exist which may be measured differently by different psa tests.Findings of this kind have occasionally been reported for psa tests from various manufacturers." the investigation did not identify a product problem.
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