FDA Adverse Event Malfunction Summary report: N

COAGUCHEK INRANGE

MDR report key: 20453602 · Received October 15, 2024

Report

Report Number
1823260-2024-02982
Event Type
Malfunction
Date Received
October 15, 2024
Date of Event
September 3, 2024
Report Date
November 15, 2024
Manufacturer
ROCHE DIAGNOSTICS
Product Code
GJS
PMA / PMN Number
K170960
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE INVESTIGATION DID NOT IDENTIFY A PRODUCT PROBLEM.

Additional Manufacturer Narrative · 0

MANUFACTURERS REF# (B)(4). G4) SIMILAR TO DEVICE MARKETED UNDER PMA/510(K): P140016. INVESTIGATION IS STILL IN PROGRESS. THIS REPORT IS REQUIRED BY THE FDA UNDER 21CFR PART 803. THIS REPORT IS BASED ON UNCONFIRMED INFORMATION SUBMITTED BY OTHERS. NEITHER THE SUBMISSION OF THIS REPORT NOR ANY STATEMENT MADE IN IT IS INTENDED TO BE AN ADMISSION THAT ANY COOK DEVICE IS DEFECTIVE OR MALFUNCTIONED; THAT A DEATH OR SERIOUS INJURY OCCURRED; OR THAT ANY COOK DEVICE CAUSED OR CONTRIBUTED TO; OR IS LIKELY TO CAUSE OR CONTRIBUTE TO A DEATH OR SERIOUS INJURY IF A MALFUNCTION OCCURRED.

Description of Event or Problem · 0

THERE WAS AN ALLEGATION OF QUESTIONABLE RESULTS FROM THE COAGUCHEK INRANGE METER COMPARED TO A STAGO ST4 LABORATORY METHOD. ON 03-SEP-2024, THE METER RESULT WAS 4.8 INR.THE LABORATORY RESULT WAS 2.5 INR.ON 14-SEP-2024, THE METER RESULT WAS 5.2 INR.THE LABORATORY RESULT WAS 3.17 INR.THE TIME INTERVAL BETWEEN THE TESTS WAS NOT PROVIDED. THE PATIENT¿S THERAPEUTIC RANGE IS 2.5 - 3.5 INR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
324038 COAGUCHEK INRANGE PROTHROMBIN TIME MONITOR GJS ROCHE DIAGNOSTICS

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown CORDARON.| SIMVASTATINE.| SINTROM.| XATRAL.| ZOCOR.