FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 2123366 · Received June 10, 2011

Report

Report Number
2027969-2011-01302
Event Type
Malfunction
Date Received
June 10, 2011
Date of Event
May 11, 2011
Report Date
June 10, 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 ANOTHER POINT OF CARE (POC) METER: DATE: (B)(6) 2011; INRATIO: 4.7. DATE: (B)(6) 2011; INRATIO: 3.7; POC METER: 2.8. PT'S TARGET THERAPEUTIC RANGE IS 2.5-3.5. PT SKIPPED HER DOSE ON (B)(6) 2011 AFTER GETTING A 4.7 RESULT ON HER METER.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1