FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 1804693 · Received August 6, 2010

Report

Report Number
2027969-2010-01150
Event Type
Malfunction
Date Received
August 6, 2010
Date of Event
July 16, 2010
Report Date
August 6, 2010
Manufacturer
BIOSITE INCORPORATED
Product Code
GJS
PMA / PMN Number
K0201923
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING.

Description of Event or Problem · 1

CUSTOMER REPORTED DISCREPANT RESULTS: UNKNOWN LOT WAS USED FOR METER TEST ON (B)(6) 2010. LOT #233708 WAS USED FOR METER TESTS ON (B)(6) 2010 AND (B)(6) 2010. VENOUS BLOOD WAS USED ON THE METER ON (B)(6) 2010.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO PROTHROMBIN TIME TEST GJS BIOSITE INCORPORATED 100007 233708

Patients

Seq Age Sex Outcome Treatment
1 Other