BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    INRATIO

    MDR report key: 2213862 · Received August 5, 2011

    Report

    Report Number
    2027969-2011-01740
    Event Type
    Malfunction
    Date Received
    August 5, 2011
    Date of Event
    June 28, 2011
    Report Date
    August 5, 2011
    Manufacturer
    ALERE SAN DIEGO, INC.
    Product Code
    GJS
    PMA / PMN Number
    K021923
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    CALLER ALLEGED DISCREPANT RESULTS USING THE INRATIO METER. METER AND LAB TESTING 28 MINUTES APART. PT SELF TESTER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100071 243394

    Patients

    Seq Age Sex Outcome Treatment
    1