FDA Adverse Event Malfunction Summary report: N

INRATIO2

MDR report key: 2230932 · Received July 20, 2011

Report

Report Number
2027969-2011-01595
Event Type
Malfunction
Date Received
July 20, 2011
Date of Event
June 21, 2011
Report Date
July 20, 2011
Manufacturer
ALERE SAN DIEGO, INC
Product Code
GJS
PMA / PMN Number
072727
Removal / Correction Number
NI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WA, 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 DOCTOR'S POINT-OF-CARE (POC). RESULTS AS FOLLOWS: DATE: (B)(6) 2011, INRATIO2: 4.0, POC: 3.1. PATIENT'S THERAPEUTIC RANGE: 2.5-3.5 INR. HISTORICALLY, PATIENT IS AROUND 2.8 INR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO2 PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC 100071 243104

Patients

Seq Age Sex Outcome Treatment
1 NI