FDA Adverse Event Malfunction Summary report: N

PROTIME MICROCOAGULATION SYSTEM

MDR report key: 2193242 · Received July 13, 2011

Report

Report Number
2248721-2011-00084
Event Type
Malfunction
Date Received
July 13, 2011
Date of Event
May 23, 2011
Report Date
June 14, 2011
Manufacturer
INTERNATIONAL TECHNIDYNE CORP.
Product Code
GKP
PMA / PMN Number
K951072
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4): DEVICE HISTORY RECORD REVIEWED FOR NCMR. NO PRODUCT RETURNED. RECORD EVAL COMPLETED. PRODUCT MET ALL RELEASE CRITERIA. DEVICE NOT RETURNED. NO CONCLUSION CAN BE DRAWN.

Description of Event or Problem · 1

A HEALTHCARE PROFESSIONAL REPORTS READING WITH PROTIME MICROCOAGULATION SYSTEM DIFFERED FROM VENOUS DRAW. PROTIME GENERATED INR 2.3. THE FOLLOWING DAY, PT TESTED IN PHYSICIAN'S OFFICE ON DIFFERENT POINT OF CARE INSTRUMENT AND GENERATED INR 4.8. THE PT'S THERAPEUTIC RANGE 2.5 TO 3.5. NO ADVERSE EVENT(S) REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROTIME MICROCOAGULATION SYSTEM GKP INTERNATIONAL TECHNIDYNE CORP. PROTIMEPST

Patients

Seq Age Sex Outcome Treatment
1