FDA Adverse Event
Malfunction
Summary report: N
PROTIME MICROCOAGULATION SYSTEM
MDR report key: 1711828
·
Received September 10, 2009
Report
- Report Number
- 2248721-2009-00434
- Event Type
- Malfunction
- Date Received
- September 10, 2009
- Date of Event
- October 31, 2007
- Report Date
- September 2, 2009
- Manufacturer
- INTERNATIONAL TECHNIDYNE CORP.
- Product Code
- GKP
- PMA / PMN Number
- K951072
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
(B)(4). THIS MDR IS SUBMITTED BASED UPON A RETROSPECTIVE REVIEW OF COMPLAINT REPORTS FROM 2007-2008 IN LIGHT OF REVISED ITC MDR EVAL PROCEDURES.
Description of Event or Problem · 1
REPORT FOR PT 1 OF 3: A 1.9 INR WITH PROTIME SYSTEM, LOT NUMBER H7K3C288 VS. 1.3 INR WITH PROTIME SYSTEM, LOT NUMBER H7KWC078A. PT THERAPEUTIC INR RANGE: NOT GIVEN. NO REPORT OF ADVERSE EVENT, SERIOUS INJURY, OR INTERVENTION.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | PROTIME MICROCOAGULATION SYSTEM | PROTIME INSTRUMENT | GKP | INTERNATIONAL TECHNIDYNE CORP. | L11-01-01 | H7K3C288 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |