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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SIEMENS HEALTHCARE DIAGNOSTICS INC. DIMENSION®; DIMENSION® EXL¿ 200 INTEGRATED CHEMISTRY SYSTEM

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SIEMENS HEALTHCARE DIAGNOSTICS INC. DIMENSION®; DIMENSION® EXL¿ 200 INTEGRATED CHEMISTRY SYSTEM Back to Search Results
Model Number DIMENSION® EXL¿ 200 SYSTEM
Medical Device Problem Code Low Test Results (2458)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/22/2023
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
An outside united states (ous) customer contacted the siemens healthcare diagnostics customer care center (ccc) regarding a falsely depressed sodium (na) result obtained on a dimension® exl¿ 200 integrated chemistry system.Siemens is investigating the event.
 
Event or Problem Description
A discordant falsely depressed sodium (na) patient sample result was obtained on a dimension® exl¿ 200 integrated chemistry system.The falsely depressed patient result was not reported to the physician.The same sample was reprocessed on the same dimension® exl¿ 200 integrated chemistry system.The higher result obtained was considered correct and reported to the physician.There are no known reports of patient intervention or adverse health consequences due to the falsely depressed sodium (na) result.
 
Additional Manufacturer Narrative
Additional information (12-sept-2023): siemens healthcare diagnostics headquarters support center (hsc) concluded the investigation of the event.Hsc reviewed the information provided by the customer.Calibration and quality control were within the customer's expected range.Hsc observed the issue was due to insufficient volume of standard a solution.The issue was resolved by replacing the standard a solution on the system.A potential product issue was not identified.The system is operational.The device is performing within specifications.No further evaluation is required.Section h6 has been updated to reflect the hsc investigation.Initial mdr 2517506-2023-00186 was filed on 30-aug-2023.
 
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Brand Name
DIMENSION®
Common Device Name
DIMENSION® EXL¿ 200 INTEGRATED CHEMISTRY SYSTEM
Manufacturer (Section D)
SIEMENS HEALTHCARE DIAGNOSTICS INC.
500 gbc drive
po box 6101
newark DE 19714 6101
Manufacturer (Section G)
SIEMENS HEALTHCARE DIAGNOSTICS INC
101 silvermine road
registration #: 1226181
brookfield CT 06804
Manufacturer Contact
linda barletta
500 gbc drive
po box 6101
newark, DE 19714-6101
MDR Report Key17652324
Report Number2517506-2023-00186
Device Sequence Number15257121
Product Code JJE
UDI-Device Identifier00842768037214
UDI-Public00842768037214
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
K130276
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Y
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 10/04/2023
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
Operator of Device Health Professional
Device Model NumberDIMENSION® EXL¿ 200 SYSTEM
Device Catalogue NumberSMN 10636928
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 08/22/2023
Supplement Date Received by Manufacturer09/12/2023
Initial Report FDA Received Date08/30/2023
Supplement Report FDA Received Date10/04/2023
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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