MAUDE Adverse Event Report: ROCHE DIAGNOSTICS ELECSYS TSH V2; RADIOIMMUNOASSAY, THYROID-STIMULATING HORMONE

Model Number	TSH
Medical Device Problem Code	High Test Results (2457)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event	Malfunction
Event or Problem Description
1.Describe the event: there was an allegation of questionable elecsys tsh v2 results for 4 patient samples from cobas e 801 analytical units.2.Patient age range: 4 years, 3-asku.3.Patient weight range: asku.4.Patient sex breakdown: 1-female, 1-male, 2-asku.5.Patient race breakdown: asku.6.Patient ethnicity breakdown: asku.
Additional Manufacturer Narrative
Reagent lot 868935 had an expiration date of 30-sep-2026.The expiration dates for reagent lots 84492900, 838516, and 911795 were not provided.For 2 events: 1.Summary of investigation results: the investigation is ongoing.2.Summary of follow up/corrective actions taken: the sample was received for investigation.For 1 event: 1.Summary of investigation results: the investigation is ongoing.2.Summary of follow up/corrective actions taken: the investigation is ongoing.For 1 event: 1.Summary of investigation results: the investigation did not identify a product problem.2.Summary of follow-up/corrective actions taken: the patient sample is not available for investigation.For all 4 events: 3.Device returned to manufacturer? no.4.Device labeled "for single use?" no.5.Device reprocessed and reused? no.
Additional Manufacturer Narrative
For one event, the investigation determined the patient's sample contains an interfering factor against the ruthenium component of the assay.Per product labeling, "in rare cases, interference due to extremely high titers of antibodies to analyte-specific antibodies, streptavidin or ruthenium can occur.These effects are minimized by suitable test design." no follow-up actions were taken.For the 2nd event: 1.Summary of investigation results: the investigation did not identify a product problem.The root cause was due to a detected interference factor in the sample.Per product labeling, "in rare cases, interference due to extremely high titers of antibodies to analyte-specific antibodies, streptavidin or ruthenium can occur.These effects are minimized by suitable test design." and "for diagnostic purposes, the results should always be assessed in conjunction with the patient¿s medical history, clinical examination and other findings." 2.Summary of follow-up/corrective actions taken: no follow-up/corrective actions were taken.For the third event: 1.Summary of investigation results: the investigation did not identify a product problem.2.Summary of follow-up/corrective actions taken: the patient sample was received for investigation and no interfering factors were identified.Based on the available data, a general reagent issue could be excluded.

• Brand Name: ELECSYS TSH V2
• Common Device Name: RADIOIMMUNOASSAY, THYROID-STIMULATING HORMONE
• Manufacturer (Section D): ROCHE DIAGNOSTICS; 9115 hague road; indianapolis IN 46250 0457
• Manufacturer (Section G): ROCHE DIAGNOSTICS GMBH; sandhofer strasse 116; mannheim (baden-wurttemberg) 68305 ; GM 68305
• Manufacturer Contact: natalie catton ; 9115 hague road; indianapolis, IN 46250
• MDR Report Key: 24183971
• Report Number: 1823260-2026-00279
• Device Sequence Number: 21336205
• Product Code: JLW
• UDI-Device Identifier: 07613336157633
• UDI-Public: 07613336157633
• Combination Product (Y/N): N
• PMA/510(K) Number: K190773
• Exemption Number: VMSR
• Number of Events Summarized: 4
• Summary Report (Y/N): Y
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 04/27/2026

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?: No
• Device Model Number: TSH
• Device Catalogue Number: 08443432190
• Device Lot Number: 868935,84492900,838516,911795
• Is the Reporter a Health Professional?: No
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: Not provided
• Supplement Date Received by Manufacturer: 01/23/2026
• Initial Report FDA Received Date: 01/26/2026
• Supplement Report FDA Received Date: 04/27/2026
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1
• Patient Sex: Unknown