BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    INRATIO

    MDR report key: 2222388 · Received July 15, 2011

    Report

    Report Number
    2027969-2011-01564
    Event Type
    Malfunction
    Date Received
    July 15, 2011
    Date of Event
    June 9, 2011
    Report Date
    July 15, 2011
    Manufacturer
    ALERE SAN DIEGO, INC
    Product Code
    GJS
    PMA / PMN Number
    K021923
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    INVESTIGATION PENDING.

    Description of Event or Problem · 1

    CALLER ALLEGED DISCREPANT RESULTS COMPARED WITH THE LAB. RESULTS AS FOLLOWS: DATE: (B)(6) 2011, LAB: 4.2; DATE: (B)(6) 2011, INRATIO: 5.4; DATE: (B)(6) 2011, INRATIO: 3.6, LAB: 3.0 (WITHIN 30 MINUTES). 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 243104

    Patients

    Seq Age Sex Outcome Treatment
    1