FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 2138893 · Received May 26, 2011

Report

Report Number
2027969-2011-01171
Event Type
Malfunction
Date Received
May 26, 2011
Date of Event
April 29, 2011
Report Date
May 26, 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: PATIENT SELF TESTER CALLED DURING TRAINING. DATE: (B)(6) 2011, INRATIO: 2.1, LOT #, 243699, COMMENTS: TOOK A LITTLE WHILE TO REGISTER BLOOD; (B)(6) 2011, 1.7, 243934, TOOK EVEN LONGER TO REGISTER BLOOD, HAD TO APPLY EXTRA DROP AS FIRST BIT WENT AROUND SAMPLE WELL; (B)(6) 2011, 2.8, 243934, METER REGISTERED BLOOD RIGHT AWAY. PATIENT TOOK HIS COUMADIN DOSE FOR THE DAY JUST BEFORE DOING THE 1ST TEST. TESTED ON A NEW FINGER EACH TIME; THE 3RD TEST WAS ABOUT 25 MINUTES AFTER THE 1ST TEST.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100071 243699

Patients

Seq Age Sex Outcome Treatment
1