FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 2040050 · Received March 9, 2011

Report

Report Number
2027969-2011-00465
Event Type
Malfunction
Date Received
March 9, 2011
Date of Event
February 4, 2011
Report Date
March 9, 2011
Manufacturer
ALERE SAN DIEGO, INC
Product Code
GJS
PMA / PMN Number
021923
Removal / Correction Number
NI
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 LAB. RESULTS AS FOLLOWS: DATE: (B)(6) 2011, INRATIO2: 3.3, LAB: 2.32. CALLER ALSO ALLEGED IMPRECISION WITH INRATIO2 METER. RESULTS AS FOLLOWS: DATE: (B)(6) 2011, INRATIO2: 3.7, 4.5. HISTORICALLY, PT STAYS BETWEEN 2.2 AND 2.5 INR. HE IS A PILOT AND IF HE GETS ABOVE 3 INR MORE THAN A COUPLE OF TIMES, HE WILL NOT BE ALLOWED TO FLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC 100071 247451

Patients

Seq Age Sex Outcome Treatment
1 NI