FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 2000220 · Received February 18, 2011

Report

Report Number
2027969-2011-00366
Event Type
Malfunction
Date Received
February 18, 2011
Date of Event
January 10, 2011
Report Date
February 18, 2011
Manufacturer
ALERE SAN DIEGO, INC
Product Code
GJS
PMA / PMN Number
K021923
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING.

Description of Event or Problem · 1

CALLER ALLEGED DISCREPANT RESULTS USING THE INRATIO METER: RESULTS AS FOLLOWS: DATE: (B)(6)2011, INRATIO: 1.0, LAB: 4.0. NURSE TESTED PATIENT IN THE HOME AND THEN WENT TO THE LAB WITHIN 30 MINUTES. CUSTOMER IS NOT SURE WHICH METER THIS OCCURRED ON SO THEY PROVIDED TWO SERIAL NUMBERS. PATIENT HAD NO BLEEDING, OR BRUISING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC 100139 237433

Patients

Seq Age Sex Outcome Treatment
1