inforMED
MalfunctionNBC

PROBNP II, N-TERMINAL PRO B-TYPE NATRIURETIC PEPTIDE

Received May 7, 2018 · Event occurred Apr 20, 2018

Report 1823260-2018-01406 · MDR key 7492031

Device

Generic name

Test,natriuretic Peptide

Manufacturer

Roche Diagnostics

Model number

NA

Catalog number

04842464190

Lot number

29280800

Product problems

  • Low Test Results
  • Low Test Results

Patient

66 YR

  • No Known Impact Or Consequence To Patient
  • No Known Impact Or Consequence To Patient

Narrative

Additional Manufacturer Narrative

(B)(4). THIS EVENT OCCURRED IN (B)(6).

Description of Event or Problem

THE CUSTOMER RECEIVED QUESTIONABLE ELECSYS PROBNP II IMMUNOASSAY RESULTS FOR ONE PATIENT. THE ERRONEOUS RESULTS WERE REPORTED OUTSIDE OF THE LABORATORY AND WERE BELIEVED TO BE NOT HIGH ENOUGH BY THE DOCTOR SINCE THE PATIENT WAS DIAGNOSED WITH ACUTE CORONARY HEART FAILURE (ACUTE CHF). THE INITIAL RESULT WAS 338 PG/ML AND THE REPEAT RESULT WAS 335.4 PG/ML. AS ANALYTE-SPECIFIC ANTIBODIES OR AN INTERFERENCE WAS SUSPECTED, THE CUSTOMER REPEATED THE SAMPLE WITH DILUTIONS. WITH A 1:2 DILUTION, THE RESULT WAS 324.7 PG/ML. WITH A 1:10 DILUTION, THE RESULT WAS 335.4 PG/ML. THERE WAS NO ALLEGATION OF AN ADVERSE EVENT. THE CUSTOMER USED COBAS E 411 IMMUNOASSAY ANALYZER SERIAL NUMBER (B)(4). AS NO SAMPLE COULD BE PROVIDED, FURTHER INVESTIGATION WAS NOT POSSIBLE. THE INVESTIGATION WAS UNABLE TO FIND A DEFINITIVE ROOT CAUSE.