FDA Adverse Event Malfunction Summary report: N

INRATIO2

MDR report key: 1954261 · Received December 9, 2010

Report

Report Number
2027969-2010-02136
Event Type
Malfunction
Date Received
December 9, 2010
Date of Event
November 17, 2010
Report Date
December 9, 2010
Manufacturer
ALERE SAN DIEGO, INC.
Product Code
GJS
PMA / PMN Number
K072727
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NE, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING.

Description of Event or Problem · 1

CALLER ALLEGED DISCREPANT RESULTS COMPARED WITH ANOTHER POC METER. RESULTS ARE AS FOLLOWS: DATE: (B)(6) 2010, INRATIO #1: 7.5, DIFFERENT POC METER: 1.8. (B)(6) 2010, 7.5, INRATIO #2: 1.5. COMPARISON WERE FROM TWO DIFFERENT PATIENT SAMPLES, PERFORMED WITHIN ONE HOUR OF ONE ANOTHER, AND USING THE SAME STRIP LOT NUMBER WHEN COMPARING METER 1 TO METER 2. CUSTOMER HAS TWO INRATIO METERS IN THEIR OFFICE. VENOUS BLOOD BEING USED FOR ALL TESTING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO2 PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100139 235738

Patients

Seq Age Sex Outcome Treatment
1