FDA Adverse Event Malfunction Summary report: N

PROTIME MICROCOAGULATION SYSTEM

MDR report key: 1711986 · Received September 10, 2009

Report

Report Number
2248721-2009-00473
Event Type
Malfunction
Date Received
September 10, 2009
Date of Event
December 19, 2007
Report Date
August 18, 2009
Manufacturer
INTERNATIONAL TECHNIDYNE CORP.
Product Code
GKP
PMA / PMN Number
K951072
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

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. MANUFACTURER METHOD: NO PRODUCT RETURNED FROM USER FACILITY. MANUFACTURER RESULTS: CUSTOMER COMPLAINT COULD NOT BE CONFIRMED.

Description of Event or Problem · 1

REPORT FOR PT 3 OF 4: A 2.3 INR WITH PROTIME SYSTEM VS 1.6 INR WITH SAME PROTIME DEVICE 2 WEEKS LATER. NO REPEAT TESTING OR OTHER RESULT CONFIRMATION REPORTED. PT THERAPEUTIC INR RANGE: 2.0 - 3.0. NO REPORT OF ADVERSE EVENT, SERIOUS INJURY, OR INTERVENTIONS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROTIME MICROCOAGULATION SYSTEM PROTIME INSTRUMENT GKP INTERNATIONAL TECHNIDYNE CORP. PROTIMEPRO G7KWC071

Patients

Seq Age Sex Outcome Treatment
1 Other