FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 1811223 · Received August 11, 2010

Report

Report Number
2027969-2010-01182
Event Type
Malfunction
Date Received
August 11, 2010
Date of Event
July 14, 2010
Report Date
August 11, 2010
Manufacturer
ALERE SAN DIEGO, INC
Product Code
GJS
PMA / PMN Number
021923
Removal / Correction Number
NI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING.

Description of Event or Problem · 1

CALLER ALLEGED DISCREPANT RESULTS COMPARED WITH THE LAB. RESULTS AS FOLLOWS: CUSTOMER RUNS ABOUT 140 TESTS A MONTH. CUSTOMER CALLED BACK AND RECEIVED THE FOLLOWING VALUES WITH NEW STRIP LOT (234586):

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC 100139 232887

Patients

Seq Age Sex Outcome Treatment
1 NI