FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 1893871 · Received November 1, 2010

Report

Report Number
2027969-2010-01840
Event Type
Malfunction
Date Received
November 1, 2010
Date of Event
October 11, 2010
Report Date
November 1, 2010
Manufacturer
ALERE SAN DIEGO, INC.
Product Code
GJS
PMA / PMN Number
K021923
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING.

Description of Event or Problem · 1

PATIENT SELF TESTER REPORTS DISCREPANT RESULTS WITH METER COMPARED TO LAB. DATE: UNK, INRATIO: 3.6. DATE: UNK, LAB: 1.8. TIME BETWEEN RESULTS WAS APPROX 1 WEEK.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1