FDA Adverse Event Malfunction Summary report: N

INRATIO2

MDR report key: 1972979 · Received January 20, 2011

Report

Report Number
2027969-2011-00148
Event Type
Malfunction
Date Received
January 20, 2011
Date of Event
December 30, 2010
Report Date
January 20, 2011
Manufacturer
ALERE SAN DIEGO, INC
Product Code
GJS
PMA / PMN Number
J072727
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 REFERENCE. RESULTS AS FOLLOWS:" DATE: (B)(6) 2010; INRATIO: 2.6; REFERENCE, DOCTOR'S METER (MANUFACTURER UNKNOWN): 2.6. DATE: (B)(6) 2010; INRATIO: 1.4, 1.9, 1.6; REFERENCE, DOCTOR'S METER (MANUFACTURER UNKNOWN): 3.0. TODAY, PATIENT OBSERVED INR=1.4 WITH INRATIO, REPEATED TEST, INR=1.9. TESTED AT DOCTOR'S OFFICE WITH DOCTOR'S METER, INR=3.0. REPEATED TEST WITH INRATIO METER, INR=1.6. PREVIOUS INR RESULT ON (B)(6) 2010 = 2.6, WHICH CONFIRMED AT DOCTOR'S OFFICE WITH DOCTOR'S METER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO2 PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC 100139 237431

Patients

Seq Age Sex Outcome Treatment
1