FDA Adverse Event Malfunction Summary report: N

INRATIO2

MDR report key: 2230947 · Received July 20, 2011

Report

Report Number
2027969-2011-01599
Event Type
Malfunction
Date Received
July 20, 2011
Date of Event
June 23, 2011
Report Date
July 20, 2011
Manufacturer
ALERE SAN DIEGO, INC.
Product Code
GJS
PMA / PMN Number
K072727
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING.

Description of Event or Problem · 1

CUSTOMER ALLEGED DISCREPANT RESULTS USING THE INRATIO2 METER. RESULTS AS FOLLOWS: DATE: (B)(6) 2011, INRATIO: 4.3, RE-TEST: 1.3. RE-TEST DONE WITHIN 5 MINUTES. PT SPECIFICS: UNK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INRATIO2 PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100139 251114

Patients

Seq Age Sex Outcome Treatment
1