FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 1911492 · Received November 18, 2010

Report

Report Number
2027969-2010-02002
Event Type
Malfunction
Date Received
November 18, 2010
Date of Event
October 21, 2010
Report Date
November 18, 2010
Manufacturer
ALERE SAN DIEGO, INC
Product Code
GJS
PMA / PMN Number
K021923
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING.

Description of Event or Problem · 1

CALLER PERFORMED A CORRELATION STUDY.

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