FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 2220096 · Received August 12, 2011

Report

Report Number
2027969-2011-01800
Event Type
Malfunction
Date Received
August 12, 2011
Date of Event
June 29, 2011
Report Date
August 12, 2011
Manufacturer
ALERE SAN DIEGO, INC.
Product Code
GJS
PMA / PMN Number
K021923
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

PENDING.

Description of Event or Problem · 1

CUSTOMER ALLEGES DISCREPANT RESULTS WITH METER. PT'S TARGET THERAPEUTIC RANGE IS 2.5-3.5. DOSE HAS BEEN ADJUSTED SEVERAL TIMES DUE TO HIGH RESULTS ON METER. ON (B)(6) 2011, RESULT DONE WITH LOT #246050. DATA HAS NO COMPARATOR AND WOULD NOT BE REPORTABLE BY ITSELF, BUT HAS BEEN INCLUDED ON THIS REPORT IN AN EFFORT TO PROVIDE ALL AVAILABLE INFO. THE 4.1 RESULT ON (B)(6) 2011 WAS DONE WITH LOT #248203. THIS LOT WAS REPORTED ON MDR # 2027969-2011-01799, BUT HAS BEEN INCLUDED ON THIS REPORT BECAUSE THE TWO LOTS ARE BEING COMPARED TO ONE ANOTHER.

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