FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 2076170 · Received March 31, 2011

Report

Report Number
2027969-2011-00668
Event Type
Malfunction
Date Received
March 31, 2011
Date of Event
March 5, 2011
Report Date
March 31, 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
MD, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING. ADD'L LOT # 243103.

Description of Event or Problem · 1

CALLER ALLEGED DISCREPANT RESULTS COMPARED WITH THE LAB. CALLER ALSO REPORTED IMPRECISION WITH INRATIO METER. RESULTS AS FOLLOWS: DATE: (B)(6) 2011, INRATIO2: 5.5, 5.3. NURSE PERFORMED TESTS ON (B)(6) 2011 AND PT PERFORMED TESTS ON (B)(6) 2011 AND (B)(6) 2011. PT'S THERAPEUTIC RANGE: 2.5-3.5 INR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100071 234526

Patients

Seq Age Sex Outcome Treatment
1 NI