FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 2123392 · Received June 10, 2011

Report

Report Number
2027969-2011-01314
Event Type
Malfunction
Date Received
June 10, 2011
Date of Event
May 10, 2011
Report Date
June 10, 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
NC, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING.

Description of Event or Problem · 1

CALLER ALLEGED DISCREPANT RESULTS COMPARED WITH THE LAB. RESULTS AS FOLLOWS: DATE: (B)(6) 2011, INRATIO: 3.8, LAB: 2.7. PT'S THERAPEUTIC RANGE: 2.0-3.0 INR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100139 247456

Patients

Seq Age Sex Outcome Treatment
1 NI