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

Catalog Number	07P57-20
Medical Device Problem Code	Low Test Results (2458)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	12/06/2023
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
An evaluation is in process.A follow-up report will be submitted when the evaluation is complete.Section a1 - patient identifier complete entry = sample id (b)(6) and sample id (b)(6) all available patient information was included.Additional patient details are not available.
Event or Problem Description
The customer observed falsely decreased calcium (ca) for one patient on an alinity c analyzer.The following data was provided (customer¿s normal range for ca is 2.15-2.5 mmol/l): sample id (b)(6) initial ca result, on (b)(6) 2024, was 1.361, repeat on another analyzer was 2.025, repeat with a different sid, on (b)(6) 2024, was 2.29 mmol/l; previous ca results on (b)(6) 2023 with sample id (b)(6), were 1.09, 1.23, 1.44, and 1.45 mmol/l.There was no impact to patient management reported.
Event or Problem Description
The customer observed falsely decreased calcium (ca) for one patient on an alinity c analyzer.The following data was provided (customer¿s normal range for ca is 2.15-2.5 mmol/l): sample id (b)(6) initial ca result, on (b)(6) 2024, was 1.361, repeat on another analyzer was 2.025, repeat with a different sid, on (b)(6) 2024, was 2.29 mmol/l; previous ca results on (b)(6) 2023 with sample id (b)(6), were 1.09, 1.23, 1.44, and 1.45 mmol/l.There was no impact to patient management reported.
Additional Manufacturer Narrative
Section d4 - primary udi number updated from (b)(4).The complaint investigation for falsely decreased alinity c calcium results included a review of data 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.Trending review determined no related trend for the issue for the product.Manufacturing documentation for the likely cause lot was reviewed and did not identify any issues.Device history record review on lot number 26375un23 did not identify any non-conformances or deviations with the likely cause lot.The customer retested the sample with the same reagent and result was normal.To further investigate the customer¿s issue, the historical performance of reagent lot 26375un23 was evaluated using world-wide data gathered from customers.The patient data was analyzed and compared to an established control limit.This evaluation indicated that the patient median result for lot 26375un23 is within the established control limits, suggesting that the performance is acceptable.Labeling was reviewed and found to adequately address the issue.Based on the information provided and abbott diagnostics¿ complaint investigation, no systemic issue or deficiency for alinity c calcium reagent lot number 26375un23, was identified.

• 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: 18867448
• Report Number: 3002809144-2024-00065
• Device Sequence Number: 18112774
• Product Code: CJY
• UDI-Device Identifier: 00380740132613
• UDI-Public: (01)00380740132613(17)240501(10)26375UN23
• Combination Product (Y/N): N
• Initial Reporter Country: SW
• 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): 05/22/2024

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: 26375UN23
• 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: 02/19/2024
• Supplement Date Received by Manufacturer: 05/10/2024
• Initial Report FDA Received Date: 03/08/2024
• Supplement Report FDA Received Date: 05/22/2024
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 05/22/2023
• 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)
• Patient Sex: Unknown