FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 2220105 · Received August 12, 2011

Report

Report Number
2027969-2011-01799
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 COMPARED TO LAB: DATE: (B)(6) 2011, INRATIO: 4.8. DATE: (B)(6) 2011, INRATIO: 3.3, LAB: 2.5, ISTAT METER: 2.4. PT'S TARGET THERAPEUTIC RANGE IS 2.5 - 3.5. DOSE HAS BEEN ADJUSTED SEVERAL TIMES DUE TO HIGH RESULTS ON METER. RESULTS DONE WITHIN 7 MINUTES OF EACH OTHER ON (B)(6) 2011.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100071 248203

Patients

Seq Age Sex Outcome Treatment
1