BEUDAMED
    FDA Adverse Event Injury Summary report: N

    INRATIO

    MDR report key: 1853330 · Received September 30, 2010

    Report

    Report Number
    2027969-2010-01616
    Event Type
    Injury
    Date Received
    September 30, 2010
    Date of Event
    September 14, 2010
    Report Date
    September 30, 2010
    Manufacturer
    ALERE SAN DIEGO, INC.
    Product Code
    GJS
    PMA / PMN Number
    K021923
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, 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: DATE: (B)(6) 2010, INRATIO: 2.3. METER WAS DROPPED BY CLEANING LADY. DATE: (B)(6) 2010, INRATIO: 4.6. PT SKIPPED TWO COUMADIN DOSES AS INSTRUCTED BY DOCTOR. DATE: (B)(6) 2010, INRATIO: 3.8, RE-TEST: 4.4. RE-TEST WAS DONE ON A DIFFERENT FINGER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100071 221730

    Patients

    Seq Age Sex Outcome Treatment
    1 Other