FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 2201028 · Received July 1, 2011

Report

Report Number
2027969-2011-01459
Event Type
Malfunction
Date Received
July 1, 2011
Date of Event
June 27, 2011
Report Date
July 1, 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
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING. TESTING WAS PERFORMED ON BOTH THE INRATIO AND INRATIO2. THE 510 (K) NUMBER LISTED IS FOR THE INRATIO. THE 510 (K) NUMBER FOR THE INRATIO2 IS K072727.

Description of Event or Problem · 1

"CALLER ALLEGED DISCREPANT RESULTS COMPARED WITH THE LAB. RESULTS AS FOLLOWS:" DATE: (B)(6) 2011, INRATIO: >7, INRATIO2: 7.3, LAB: 4.1. CUSTOMER HAS BEEN GETTING DISCREPANT HIGH RESULTS ON SEVERAL PTS. THIS PT HAS BEEN EATING PLENTY OF SALADS AND GREENS. NO OTHER DATA PROVIDED FOR THE OTHER PTS. SEVERAL PTS HAD THEIR COUMADIN DOSE CHANGED BASED ON THE INRATIO RESULTS. CALLER TESTED HERSELF YESTERDAY (NON-COUMADIN) INRATIO = 1.4; INRATIO2 = 1.5.

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