FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 2082598 · Received April 27, 2011

Report

Report Number
2027969-2011-00936
Event Type
Malfunction
Date Received
April 27, 2011
Date of Event
April 5, 2011
Report Date
April 27, 2011
Manufacturer
ALERE SAN DIEGO, INC.
Product Code
GJS
PMA / PMN Number
K021923
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING.

Description of Event or Problem · 1

CALLER ALLEGED DISCREPANT RESULTS USING THE INRATIO METER: RESULTS AS FOLLOWS: DATE: (B)(6) 2011, INRATIO: 3.3, DOCTOR'S INRATIO2: 2.6, LAB: 2.3 PT SELF TESTER TESTED ON HIS DOCTOR'S INRATIO2 METER, HIS METER AND AT THE LAB. PT REPORTS THAT THE SAME FINGER STICK WAS USED FOR BOTH THE DOCTOR'S METER AND PT'S METER. TESTING WAS DONE THE SAME DAY WITHIN AN HOUR FROM THE LAB, A VENOUS SAMPLE WAS USED OF THE LAB.

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