MAUDE Adverse Event Report: ABBOTT GMBH ALINITY C CALCIUM REAGENT KIT; AZO DYE, CALCIUM

Catalog Number	07P57-20
Medical Device Problem Code	High Test Results (2457)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	11/07/2023
Type of Reportable Event	Malfunction
Event or Problem Description
The customer observed falsely elevated alinity c calcium results for one sample.The following data was provided: sid:(b)(6), initial result (b)(6) = 2.57 mmol/l, repeat = 3.51 mmol/l (abnormal curve), repeat on another alinity (b)(6) = 3.72 mmol/l.The customer performed a precision test on sid: (b)(6) for troubleshooting purposes (units of measure = mmol/l): alinity 1 (b)(6): 2.66, 2.74, 2.73, 2.71, 2.71, 2.61, 2.70, 2.74, 2.88, 2.93.Alinity 2 (b)(6): 2.51, 2.5, 2.46, 2.49, 2.52, 2.47, 2.48, 2.51, 2.48, 2.55.The sample was repeated after aliquoting the sample: alinity 1 (b)(6) = 2.34 mmol/l, alinity 2 (b)(6) = 2.31 mmol/l.A comparison study was completed with 30 patient samples and no discrepant results were generated/reported.No impact to patient management was reported.
Additional Manufacturer Narrative
An evaluation is in process.A follow-up report will be submitted when the evaluation is complete.
Additional Manufacturer Narrative
The complaint investigation for falsely elevated alinity c calcium results included a review of data and information provided by the customer, search for similar complaints, ticket trending review, labeling review, and device history record review.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.A search for similar complaints did not identify an increase in complaint activity for lot 02298un23.A review of tracking and trending did not identify any trends for the issue for the product.Device history review did not identify any non-conformances or deviations with lot 02298un23 and the complaint issue.Labeling was reviewed and sufficiently addresses the customer¿s issue.Based on the investigation, no systemic issue or deficiency of the alinity c calcium reagent lot 02298un23 was identified.
Event or Problem Description
The customer observed falsely elevated alinity c calcium results for one sample.The following data was provided: sid (b)(6) initial result ((b)(6)) = 2.57 mmol/l, repeat = 3.51 mmol/l (abnormal curve), repeat on another alinity ((b)(6)) = 3.72 mmol/l the customer performed a precision test on sid (b)(6) for troubleshooting purposes (units of measure = mmol/l): alinity 1 ((b)(6)): 2.66, 2.74, 2.73, 2.71, 2.71, 2.61, 2.70, 2.74, 2.88, 2.93 alinity 2 ((b)(6)): 2.51, 2.5, 2.46, 2.49, 2.52, 2.47, 2.48, 2.51, 2.48, 2.55 the sample was repeated after aliquoting the sample: alinity 1 ((b)(6)) = 2.34 mmol/l, alinity 2 ((b)(6)) = 2.31 mmol/l.A comparison study was completed with 30 patient samples and no discrepant results were generated/reported.No impact to patient management was reported.

• Brand Name: ALINITY C CALCIUM REAGENT KIT
• Common Device Name: AZO DYE, CALCIUM
• Manufacturer (Section D): ABBOTT GMBH; max-planck-ring 2; wiesbaden 65205 ; GM 65205
• Manufacturer (Section G): ABBOTT GMBH; max-planck-ring 2; wiesbaden 65205 ; GM 65205
• Manufacturer Contact: nicole jenne ; max-planck-ring 2; post market surveillance; wiesbaden 65205 ; GM 65205 ; 6122582960
• MDR Report Key: 18136120
• Report Number: 3002809144-2023-00468
• Device Sequence Number: 12776329
• Product Code: CJY
• UDI-Device Identifier: 00380740132613
• UDI-Public: 00380740132613
• Combination Product (Y/N): N
• Initial Reporter Country: GM
• PMA/510(K) Number: K062855
• 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): 01/08/2024

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: 05/01/2024
• Device Catalogue Number: 07P57-20
• Device Lot Number: 02298UN23
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: 11/08/2023
• Supplement Date Received by Manufacturer: 01/05/2024
• Initial Report FDA Received Date: 11/14/2023
• Supplement Report FDA Received Date: 01/08/2024
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Date Device Manufactured: 04/11/2023
• 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: ALNTY C PROCESSING MODU, 03R67-01, (B)(6) ; ALNTY C PROCESSING MODU, 03R67-01, (B)(6) ; ALNTY C PROCESSING MODU, 03R67-01, (B)(6) ; ALNTY C PROCESSING MODU, 03R67-01, (B)(6)
• Patient Sex: Unknown