FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 1833399 · Received September 8, 2010

Report

Report Number
2027969-2010-01373
Event Type
Malfunction
Date Received
September 8, 2010
Date of Event
August 18, 2010
Report Date
September 8, 2010
Manufacturer
ALERE SAN DIEGO, INC.
Product Code
GJS
PMA / PMN Number
K021923
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING.

Description of Event or Problem · 1

CUSTOMER REPORTED UNEXPECTED HIGH RESULTS FOR PATIENT. DATE: "THIS WEEK"; INRATIO: 6.6. DATE: "LAST WEEK"; 1.6.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1