BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    INRATIO

    MDR report key: 2082686 · Received April 28, 2011

    Report

    Report Number
    2027969-2011-00953
    Event Type
    Malfunction
    Date Received
    April 28, 2011
    Date of Event
    April 13, 2011
    Report Date
    April 28, 2011
    Manufacturer
    ALERE SAN DIEGO, INC.
    Product Code
    GJS
    PMA / PMN Number
    K021923
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, 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, PATIENT: 1, INRATIO: 6.6, LAB: 4.7. NG, 2, 2.3, 1.6. NG, 3, 3.3, 2.7.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100139 251112

    Patients

    Seq Age Sex Outcome Treatment
    1