BEUDAMED
    FDA Adverse Event Other Summary report: N

    INRATIO

    MDR report key: 1915173 · Received November 30, 2010

    Report

    Report Number
    2027969-2010-02071
    Event Type
    Other
    Date Received
    November 30, 2010
    Date of Event
    November 8, 2010
    Report Date
    November 29, 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

    PATIENT SELF TESTER HAD LAST VALID METER TESTING ON (B)(6) 2010, METER INR=2.4. PATIENT HAD NOSEBLEED ON (B)(6) 2010.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100071 237411

    Patients

    Seq Age Sex Outcome Treatment
    1 Other