inforMED
MalfunctionCDX

THYROXINE

Received May 20, 2011 · Event occurred Apr 24, 2011

Report 1823260-2011-02621 · MDR key 2098156

Device

Generic name

Radioassay, Triiodothyronine Uptake

Manufacturer

Roche Diagnostics

Model number

NA

Catalog number

12017709160

Lot number

16138601

Product problems

  • High Test Results

Patient

064 YR

  • No Consequences Or Impact To Patient

Narrative

Additional Manufacturer Narrative

(B)(6).

Additional Manufacturer Narrative

THE INVESTIGATION DETERMINED THE CAUSE TO BE THE LEAKING DETECTION UNIT WHICH WAS DISCOVERED BY THE FIELD SERVICE REPRESENTATIVE. HE FOUND LIQUID HAD LEAKED ON A PCB BOARD AND CHANGED THE BOARD. THE ISSUE WAS SOLVED BY THE REPLACEMENT OF THE WHOLE DETECTION UNIT. NO PATIENTS WERE AFFECTED IN ANY WAY.

Description of Event or Problem

THE USER RECEIVED QUESTIONABLE T4 RESULTS FOR AN UNKNOWN NUMBER OF PATIENT SAMPLES FROM THE COBAS E601 ANALYZER SERIAL NUMBER (B)(4). OF THE PROVIDED DATA, THE RESULT FOR ONE PATIENT SAMPLE WAS DISCREPANT AND REPORTED OUTSIDE THE LABORATORY. THE INITIAL RESULT WAS 24.86 UG/DL AND THE REPEAT RESULT ON (B)(6) 2011 WAS 10.33 UG/DL. NO ADVERSE EVENTS WERE ALLEGED REGARDING THE ISSUE. UPON EVALUATION OF THE ANALYZER, THE FIELD SERVICE REPRESENTATIVE DETERMINED THE DETECTION UNIT WAS DAMAGED DUE TO FLUID. HE REPLACED THE DETECTION UNIT AND VERIFIED THE ANALYZER OPERATION BY RUNNING PERFORMANCE TESTING WITH RESULTS WITHIN SPECIFICATIONS.