FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 2070755 · Received April 14, 2011

Report

Report Number
2027969-2011-00832
Event Type
Malfunction
Date Received
April 14, 2011
Date of Event
March 23, 2011
Report Date
April 14, 2011
Manufacturer
ALERE SAN DIEGO, INC.
Product Code
GJS
PMA / PMN Number
K021923
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

CUSTOMER ALLEGES DISCREPANT RESULTS WITH METER COMPARED TO LAB: PATIENT #2: DATE: (B)(6) 2011, INRATIO: 1.4, RETEST INRATIO: 3.1, PRETEST INRATIO: 3.3, LAB: 4.1, RETEST LAB: 4.2. FIRST INRATIO TEST DONE AT 11AM. THE 2 INRATIO RETESTS WERE DONE AT 3:15PM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100139 237431

Patients

Seq Age Sex Outcome Treatment
1