FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 1923872 · Received December 8, 2010

Report

Report Number
2027969-2010-02132
Event Type
Malfunction
Date Received
December 8, 2010
Date of Event
November 15, 2010
Report Date
December 8, 2010
Manufacturer
ALERE SAN DIEGO, INC.
Product Code
GJS
PMA / PMN Number
021923
Removal / Correction Number
NI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, 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: PATIENT 1, DATE: (B)(6) 2010, INRATIO: 7.5, LAB: 3.94. PATIENT 2, INRATIO: 3.1, LAB: 2.2. CUSTOMER REPORTS DISCREPANT HIGH RESULTS IN (B)(6).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100139 232888

Patients

Seq Age Sex Outcome Treatment
1 NI