inforMED
MalfunctionJFP

ISE 9180

Received Mar 12, 2010 · Event occurred Feb 23, 2010

Report 1823260-2010-01570 · MDR key 1629515

Device

Generic name

Blood Gas Analyzer

Manufacturer

Roche Diagnostics

Model number

NA

Catalog number

03157334001

Lot number

NA

Product problems

  • Incorrect Or Inadequate Test Results

Patient

Not reported

  • No Consequences Or Impact To Patient

Narrative

Description of Event or Problem

THE USER RECEIVED ANALYZER ALARMS AND DISCREPANT LITHIUM RESULTS FOR ONE PATIENT SAMPLE. THE RESULTS WERE 1.02, 0.98, 0.94, 1.07, 0.85 AND 0.98 MMOL/L. THE PATIENT RESULTS WERE NOT REPORTED AND NO ACTIONS WERE TAKEN BASED ON THE RESULTS. THE LOT NUMBER OF THE LITHIUM ELECTRODE WAS NOT PROVIDED. INVESTIGATION DETERMINED THE CAUSE WAS A DEFECTIVE MAINBOARD AND REFERENCE VALVE WHICH WERE REPLACED. THE ANALYZER OPERATION WAS VERIFIED BY A SAMPLE SENSOR TEST, SERVICE TESTING, ADJUSTMENTS AND QC TESTING WITH ALL RESULTS PASSING.

Additional Manufacturer Narrative

IT WAS UNKNOWN IF THE INITIAL REPORTER SENT REPORT TO THE FDA.