DIMENSION VISTA®
Received Dec 5, 2022 · Event occurred Oct 21, 2022
Report 2517506-2022-00302 · MDR key 15917259
Device
Generic name
Dimension Vista® E2 Estradiol Flex® Reagent Cartridge
Manufacturer
Siemens Healthcare Diagnostics Inc.Model number
10489099Catalog number
E2 K6463 SMN 10489099
Lot number
22059BB
Product problems
- High Test Results
- High Test Results
Patient
58 YR · Female
- No Clinical Signs, Symptoms or Conditions
- No Clinical Signs, Symptoms or Conditions
Narrative
Description of Event or Problem
A DISCORDANT FALSELY ELEVATED LOCI ESTRADIOL (E2) RESULT WAS OBTAINED ON A PATIENT SAMPLE ON A DIMENSION VISTA® 500 INTELLIGENT LAB SYSTEM. THE FALSELY ELEVATED RESULT WAS REPORTED TO THE PHYSICIAN(S). THE SAME SAMPLE WAS REPROCESSED ON THE SAME INSTRUMENT, TWO ALTERNATE SIEMENS INSTRUMENTS AND ON A NON-SIEMENS SYSTEM. THE REPROCESSED RESULTS FROM THE ALTERNATE INSTRUMENTS WERE LOWER THAN THE FALSELY ELEVATED RESULT AND CONSIDERED CORRECT. THE RESULT FROM THE NON-SIEMENS SYSTEM WAS PROVIDED TO THE PHYSICIAN(S) ON A CORRECTED REPORT. THERE ARE NO KNOWN REPORTS OF PATIENT INTERVENTION OR ADVERSE HEALTH CONSEQUENCES DUE TO THE FALSELY ELEVATED E2 RESULT.
Additional Manufacturer Narrative
SIEMENS HEALTHCARE DIAGNOSTICS HEADQUARTERS SUPPORT CENTER (HSC) CONCLUDED THEIR INVESTIGATION OF THE FALSELY ELEVATED LOCI ESTRADIOL (E2) RESULT. HSC REVIEWED THE INFORMATION PROVIDED BY THE CUSTOMER. QUALITY CONTROL WAS IN RANGE AND NO ISSUES WERE NOTED WITH OTHER PATIENT SAMPLES INDICATING THAT THE DIMENSION VISTA® 500 INSTRUMENT AND E2 ASSAY WERE PERFORMING ACCEPTABLY. REPEAT PROCESSING OF THE SAME SAMPLE ON ALTERNATE METHODOLOGIES YIELDED LOWER EXPECTED RESULTS. REPEAT PROCESSING OF THE SAME SAMPLE ON THE SAME DIMENSION VISTA SYSTEM YIELDED SIMILAR ELEVATED RESULTS. DIMENSION VISTA LOCI ESTRADIOL (E2) FLEX REAGENT CARTRIDGE INSTRUCTIONS FOR USE STATES: "PATIENT SAMPLES MAY CONTAIN HETEROPHILIC ANTIBODIES THAT COULD REACT IN IMMUNOASSAYS TO GIVE FALSELY ELEVATED OR DEPRESSED RESULTS. THIS ASSAY HAS BEEN DESIGNED TO MINIMIZE INTERFERENCE FROM HETEROPHILIC ANTIBODIES. NEVERTHELESS, COMPLETE ELIMINATION OF THIS INTERFERENCE FROM ALL PATIENT SPECIMENS CANNOT BE GUARANTEED. A TEST RESULT THAT IS INCONSISTENT WITH THE CLINICAL PICTURE AND PATIENT HISTORY SHOULD BE INTERPRETED WITH CAUTION. WITH THE ADVENT OF NEW STEROID BASED MEDICATIONS (ANALOGUES) WITH SIMILAR CHEMICAL STRUCTURES TO ESTRADIOL, THERE IS THE POSSIBILITY OF CROSS-REACTIVITY AND RESULTS INCONSISTENT WITH THE PATIENTS CLINICAL HISTORY. FOR DIAGNOSTIC PURPOSES, THE RESULTS SHOULD ALWAYS BE ASSESSED IN CONJUNCTION WITH THE PATIENT'S MEDICAL HISTORY, CLINICAL EXAMINATION AND OTHER FINDINGS. IF THE ESTRADIOL RESULTS ARE INCONSISTENT WITH CLINICAL EVIDENCE, ADDITIONAL TESTING IS SUGGESTED TO CONFIRM THE RESULT." THE CAUSE OF THE PATIENT SAMPLE SPECIFIC EVENT IS UNKNOWN. A POTENTIAL PRODUCT ISSUE HAS NOT BEEN IDENTIFIED. THE DEVICE IS PERFORMING WITHIN SPECIFICATIONS. NO FURTHER EVALUATION IS REQUIRED.