FDA Adverse Event Other Summary report: N

INRATIO

MDR report key: 1864892 · Received October 6, 2010

Report

Report Number
2027969-2010-01629
Event Type
Other
Date Received
October 6, 2010
Date of Event
September 9, 2010
Report Date
October 6, 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
MN, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING.

Description of Event or Problem · 1

CUSTOMER REPORTS DISCREPANT RESULTS WITH METER COMPARED TO LAB. PATIENT #1: DATE: (B)(6) 2010; INRATIO: 4.4; RETEST INRATIO: 2.6; LAB: 4.0. HAD A 1.5 INR A WEEK PRIOR AND COUMADIN DOSE MAY HAVE BEEN CHANGED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC 100139 235793

Patients

Seq Age Sex Outcome Treatment
1 Other