MAUDE Adverse Event Report: CUE HEALTH INC. CUE COVID-19 TEST FOR HOME AND OVER THE COUNTER (OTC) USE; REAGENTS, 2019-NOVEL CORONAVIRUS NUCLEIC ACID

Model Number C2020

Device Problem Non Reproducible Results (4029)

Patient Problem Viral Infection (2248)

Event Date 03/18/2022

Event Type  malfunction  

Event Description

Customer reported on behalf of an unknown individual.Individual received a false positive result on (b)(6) 2022 using cue covid-19 test for home and over the counter (otc) use cartridge lot 16126d.The individual received two negative cue covid-19 results; date unknown.The individual did not take an outside confirmatory test, had no symptoms, or confirmed covid-19 exposure.The cartridges were stored according to the instructions for use.No further information available including patient specific information, cue cartridge serial number or cue reader serial number.

Manufacturer Narrative

Device evaluated by manufacturer: cartridges used by the consumer were not sent back for evaluation, therefore, the devices could not be evaluated.The customer provided information regarding the suspected false positive test and a member of the technical support group was able to perform data analysis.Investigation summary: the complaint history was reviewed and there were no previous similar complaints against involved lot.The lot history record (lhr) was reviewed for the lot number in the complaint, and it passed release specifications.A technical support representative reviewed customer data and performed data analysis.All data values were normal and met acceptable criteria.Root cause was undetermined.

• Brand Name: CUE COVID-19 TEST FOR HOME AND OVER THE COUNTER (OTC) USE
• Type of Device: REAGENTS, 2019-NOVEL CORONAVIRUS NUCLEIC ACID
• Manufacturer (Section D): CUE HEALTH INC.; 4980 carroll canyon rd; suite 100; san diego CA 92121
• Manufacturer Contact: roderick castillo ; 4980 carroll canyon rd; suite 100; san diego, CA 92121 ; 8332838378
• MDR Report Key: 16080868
• MDR Text Key: 308496745
• Report Number: 3016758165-2022-00649
• Device Sequence Number: 1
• Product Code: QJR
• Combination Product (y/n): N
• PMA/PMN Number: EUA210180
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Consumer
• Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial
• Report Date: 12/30/2022

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 12/30/2022
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Other
• Device Expiration Date: 04/07/2022
• Device Model Number: C2020
• Device Lot Number: 16126D
• Was Device Available for Evaluation?: No
• Date Manufacturer Received: 03/18/2022
• Was Device Evaluated by Manufacturer?: No
• Date Device Manufactured: 07/11/2021
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1