FDA Adverse Event Other Summary report: N

INRATIO

MDR report key: 1971712 · Received January 12, 2011

Report

Report Number
2027969-2011-00079
Event Type
Other
Date Received
January 12, 2011
Date of Event
December 19, 2010
Report Date
January 12, 2011
Manufacturer
ALERE SAN DIEGO, INC.
Product Code
GJS
PMA / PMN Number
K021923
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, 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:" DATE: (B)(6) 2010; INRATIO: 6.5. DATE: (B)(6) 2010; INRATIO: 7.2; LAB: 4.4. DATE: (B)(6) 2010; INRATIO: 3.7; LAB: 3.2. PHYSICIAN STOPPED COUMADIN. CUSTOMER CALLED BACK WITH LAB RESULTS ON (B)(6) 2010. PHYSICIAN REQUESTED THAT PT INSTALL NEW, FRESH BATTERIES INTO METER AND REPEAT TESTING ON A DIFFERENT LOT OF STRIPS (234523). RESULT = 6.0. PT WAS ON ANTIBIOTIC; LAST DOSE WAS 1 WEEK AGO. PT NEEDS INR VALUE STABILIZED DUE TO HAND SURGERY SCHEDULED FOR NEXT WEEK. SELF-TEST ((B)(6) DAUGHTER) INR = 1.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100071 225433

Patients

Seq Age Sex Outcome Treatment
1 Other