FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 2063048 · Received April 11, 2011

Report

Report Number
2027969-2011-00769
Event Type
Malfunction
Date Received
April 11, 2011
Date of Event
March 14, 2011
Report Date
April 11, 2011
Manufacturer
ALERE SAN DIEGO, INC
Product Code
GJS
PMA / PMN Number
K021923
Removal / Correction Number
NI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

PENDING INVESTIGATION.

Description of Event or Problem · 1

CALLER ALLEGED DISCREPANT RESULTS COMPARED WITH THE LAB FOR PT #1 AS WELL AS IMPRECISION WITH INRATIO METER FOR PT #2. RESULTS AS FOLLOWS: PT #1: INRATIO - 4.7; LAB - 2.6 (10 MINUTES LATER). PT #2: 1ST INRATIO - 6.1; 2ND INRATIO - 4.0.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC 100071 235738

Patients

Seq Age Sex Outcome Treatment
1 NI