MAUDE Adverse Event Report: BECTON DICKINSON CARIBE LTD. BD MACRO-VUE¿ RPR CARD TEST; ANTIGENS, NONTREPONEMAL, ALL

Model Number	275005
Medical Device Problem Code	False Positive Result (1227)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	05/04/2022
Type of Reportable Event	Malfunction
Event or Problem Description
It has been reported that the bd macro-vue¿ rpr card test has been found producing a false positive result.Vdrl was used for confirmatory testing.There was report of minor patient impact.The following has been provided by the initial reporter: processing of this discordant exam, gave us a complete reactive card, which being so improbable was repeated and gave non-reactive.
Additional Manufacturer Narrative
A device evaluation and/or device history review is anticipated, but is not complete.Upon completion, a supplemental report will be filed.
Additional Manufacturer Narrative
H.6: device evaluation: satisfactory results when retention samples were tested for performance using three (3) sera panel numbers of each reactivity.Control lot (2013911) customer batch number (1277599) serum no.15: all lots showed reactive results at 1:1 to 1:4 and reactive minimal at 1:8.Serum no's; 17 - 20: all lots showed reactive results at 1:1 and reactive minimal at 1:4.Serum no¿s.26, 37 and 40: all lots showed reactive minimal results at 1:1 serum no's.1, 7 and 8: all lots showed negative results.From the photo received we cannot identify positive reactive well in any of the cards reaction unable to reproduce customer experience.Complaint unconfirmed based of retention sample results, photo evaluation and batch history record review.A cross functional team continually monitors all product complaints for trends and determines if any additional actions are necessary beyond the current investigation process.Special attention should be provided to: antigen storage and use.Sample and room temperature during the test.Type of specimen used: collection and preparation.According of the ¿manual of test for syphilis¿ edition 9.0 the following ¿sources of error¿ had been identified for increase of reactivity or false reactivity for the rpr test.If the time of rotation is too long, test reactivity may be increased.If the card is excessively rotated and tilted (to and fro motions) by hand after removal from the rotator, a false reactive result may occur.If the serum is unevenly spread in the circle, the antigen and the antibody may not mix properly.
Event or Problem Description
It has been reported that the bd macro-vue¿ rpr card test has been found producing a false positive result.Vdrl was used for confirmatory testing.There was report of minor patient impact.The following has been provided by the initial reporter: processing of this discordant exam, gave us a complete reactive card, which being so improbable was repeated and gave non-reactive.

• Brand Name: BD MACRO-VUE¿ RPR CARD TEST
• Common Device Name: ANTIGENS, NONTREPONEMAL, ALL
• Manufacturer (Section D): BECTON DICKINSON CARIBE LTD.; vicks drive; lot no. 6; cayey PR
• Manufacturer (Section G): BECTON DICKINSON CARIBE LTD.; vicks drive; lot no. 6; cayey PR
• Manufacturer Contact: phillip emmert ; 9450 south state street; sandy, UT 84070 ; 8015296192
• MDR Report Key: 14639480
• Report Number: 2647876-2022-00155
• Device Sequence Number: 20263961
• Product Code: GMQ
• UDI-Device Identifier: 00382902750055
• UDI-Public: 00382902750055
• Combination Product (Y/N): N
• Initial Reporter Country: CI
• PMA/510(K) Number: PREAMENDMENT
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Other,Foreign,User Facility
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 07/11/2022

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
• Operator of Device: Other
• Device Expiration Date: 10/31/2023
• Device Model Number: 275005
• Device Catalogue Number: 275005
• Device Lot Number: 1277599
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Follow-Up
• Initial Date Received by Manufacturer: 05/17/2022
• Supplement Date Received by Manufacturer: 07/11/2022
• Initial Report FDA Received Date: 06/08/2022
• Supplement Report FDA Received Date: 08/03/2022
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Date Device Manufactured: 11/11/2021
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Patient Sex: Unknown