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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: HUMASIS CO., LTD. CELLTRION DIATRUST COVID-19 AG HOME TEST IN VITRO DIAGNOSTICS

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HUMASIS CO., LTD. CELLTRION DIATRUST COVID-19 AG HOME TEST IN VITRO DIAGNOSTICS Back to Search Results
Device Problem Computer System Security Problem (2899)
Patient Problem Insufficient Information (4580)
Event Type  malfunction  
Event Description
User left a commented on the (b)(6) website that there was an error occurred when scanning the code. It appeared as not a valid test. Importer comments: this was a phenomenon that occurs because the serial number of the product and the application for activation are not synchronized. There is no error with the diagnosis of covid-19 but activation of the application through qr code is part of the product's functionality so that we assessed this is in criteria of "malfunction" according to the 21cfr803. Due to the system functionality to not allow seller can leave the comments on the website, it is not able for us to follow up to collect additional information, such as product information (lot #, expiration date ect) following by reporter's consent.
 
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Brand NameCELLTRION DIATRUST COVID-19 AG HOME TEST
Type of DeviceIN VITRO DIAGNOSTICS
Manufacturer (Section D)
HUMASIS CO., LTD.
88, jeonpa-ro, dongan-gu
anyang-si
gyeonggi-do 14042
KS 14042
MDR Report Key13549738
MDR Text Key286767208
Report Number3008719759-2022-00046
Device Sequence Number1
Product Code QKP
Combination Product (y/n)N
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source Distributor
Reporter Occupation
Type of Report Initial
Report Date 02/16/2022
1 Device was Involved in the Event
0 Patients were Involved in the Event:
Date FDA Received02/17/2022
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Distributor Facility Aware Date01/11/2022
Event Location Home
Was Device Evaluated by Manufacturer? No Answer Provided
Is This a Reprocessed and Reused Single-Use Device? No

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