MAUDE Adverse Event Report: ABBOTT IRELAND DIAGNOSTICS DIVISION ALINITY C IRON2; BATHOPHENANTHROLINE, COLORIMETRY, IRON (NON-HEME)

Catalog Number	04T98-20
Medical Device Problem Code	High Test Results (2457)
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
All available patient information was included.Additional patient details are not available.An evaluation is in process.A follow-up report will be submitted when the evaluation is complete.
Event or Problem Description
The customer reported qc being out of range for salinity ciron 2.The customer further communicated that they randomly retested patient samples out of a total of 70 on another alinity c processing module and noted falsely elevated results.The customer was not able to provide patients¿ age and provided the following data: customer normal range: 0-14 years: 2.9 -22.9 ¿mol/l, female 14 - 19 years: 3.6 - 29.0 ¿mol/l, male 14 - 19 years: 5.5 - 30.1 ¿mol/l, adult female: 9.0 - 30.4 ¿mol/l, adult male: 11.6 - 31.3 ¿mol/l the initial result was from sn: ac02838 and repeat result was from sn: ac04137 sample initial result was 64.2, repeat result was 52.5.Per the customer the discrepant results were not reported out to the patients¿ medical provider.There was no reported impact to patient management.
Event or Problem Description
The customer reported qc being out of range for alinity c iron2.The customer further communicated that they randomly retested patient samples out of a total of 70 on another alinity c processing module and noted falsely elevated results.The customer was not able to provide patients¿ age and provided the following data: customer normal range: 0-14 years: 2.9 -22.9 mol/l, female 14 - 19 years: 3.6 - 29.0 mol/l, male 14 - 19 years: 5.5 - 30.1 mol/l, adult female: 9.0 - 30.4 mol/l, adult male: 11.6 - 31.3 mol/l the initial result was from sn: (b)(6) and repeat result was from sn: (b)(6) sample initial result was 64.2, repeat result was 52.5.Per the customer the discrepant results were not reported out to the patients¿ medical provider.There was no reported impact to patient management.
Additional Manufacturer Narrative
The complaint investigation regarding quality control being out of range, which came back in range after recalibration with falsely elevated alinity c iron2 included a review of data and information provided by the customer, search for similar complaints, ticket trending review, labeling review, device history record review, and in house testing.Return testing was not completed as returns were not available.Data and information provided by the customer were reviewed and support the complaint issue without indication for any additional issue.The ticket search by lot indicates that the reagent lot performs as expected for this product.Ticket and trending review did not identify any trends.Device history review did not identify issues associated with the customer¿s observation.In house testing was performed with for calibration stability with reagent and calibration used by the customer, which was alinity c iron2 reagent lot 51379ud00 and calibrator concc lot: 0001230ue.Testing met all validity and acceptance criteria, and the product is performing as expected.Labeling was reviewed and sufficiently addresses the customer¿s reported issue.Based on the investigation, no systemic issue or deficiency was identified for the alinity c iron2 reagent lot 51379ud00.The following fields were corrected.

• Brand Name: ALINITY C IRON2
• Common Device Name: BATHOPHENANTHROLINE, COLORIMETRY, IRON (NON-HEME)
• Manufacturer (Section D): ABBOTT IRELAND DIAGNOSTICS DIVISION; lisnamuck; co. longford; longford N39E9 32; EI N39E932
• Manufacturer (Section G): ABBOTT IRELAND DIAGNOSTICS DIVISION; lisnamuck; co. longford; longford N39E9 32; EI N39E932
• Manufacturer Contact: nicole jenne ; max-planck-ring 2; post market surveillance; wiesbaden 65205 ; GM 65205 ; 6122582960
• MDR Report Key: 17730662
• Report Number: 3005094123-2023-00239
• Device Sequence Number: 6572249
• Product Code: CFM
• UDI-Device Identifier: 00380740168285
• UDI-Public: 00380740168285
• Combination Product (Y/N): N
• Initial Reporter Country: GM
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Foreign,Health Professional
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 11/30/2023

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 Expiration Date: 06/30/2024
• Device Catalogue Number: 04T98-20
• Device Lot Number: 51379UD00
• 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: 08/23/2023
• Supplement Date Received by Manufacturer: 11/16/2023
• Initial Report FDA Received Date: 09/12/2023
• Supplement Report FDA Received Date: 11/30/2023
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Date Device Manufactured: 04/20/2023
• 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
• Patient Sequence Number: 1
• Concomitant Medical Products and Therapy/Usage Dates: ALINITY CONCC, 04V62-01, 0001230UE; ALNTY C PROCESSING MODU, 03R67-01, AC02838; ALNTY C PROCESSING MODU, 03R67-01, AC02838
• Patient Sex: Unknown