FDA Adverse Event Other Summary report: N

INRATIO

MDR report key: 1978690 · Received January 28, 2011

Report

Report Number
2027969-2011-00201
Event Type
Other
Date Received
January 28, 2011
Date of Event
January 10, 2011
Report Date
January 28, 2011
Manufacturer
ALERE SAN DIEGO
Product Code
GJS
PMA / PMN Number
K021923
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING.

Description of Event or Problem · 1

CUSTOMER ALLEGES DISCREPANT RESULTS WITH METER COMPARED TO LAB: DATE: (B)(6) 2011, INRATIO: 6.8, INRATIO: 5.6, LAB: 10.2. LAB DRAW WAS DONE AN HOUR AFTER INRATIO RESULTS. PATIENT'S TARGET THERAPEUTIC RANGE IS 2.0-3.5. PATIENT WAS ADMITTED TO THE HOSPITAL AND ADMINISTERED VITAMIN K AFTER LAB OF 10.2.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO 100071 243699

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| O