FDA Adverse Event Malfunction Summary report: N

PROTIME MICROCOAGULATION SYSTEM

MDR report key: 2548270 · Received July 31, 2009

Report

Report Number
2248721-2009-00627
Event Type
Malfunction
Date Received
July 31, 2009
Date of Event
April 1, 2008
Report Date
July 29, 2009
Manufacturer
INTERNATIONAL TECHNIDYNE CORP.
Product Code
GKP
PMA / PMN Number
K951072
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NH, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THIS MDR IS SUBMITTED BASED UPON A RETROSPECTIVE REVIEW OF COMPLAINT REPORTS FROM 2007-2008 IN LIGHT OF REVISED ITC MDR EVALUATION PROCEDURES.

Description of Event or Problem · 1

THIS REPORT IS FOR PATIENT 3 OF 3. A 4.3 INR WITH PROTIME SYSTEM VS. THERAPEUTIC INR OBTAINED WITH UNSPECIFIED LAB SYSTEM. PATIENT THERAPEUTIC RANGE 2.0 - 3.0 INR. NO REPORT OF ADVERSE EVENT, SERIOUS INJURY, OR INTERVENTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROTIME MICROCOAGULATION SYSTEM PROTIME INST/3-CHANNEL TEST CUVETTE GKP INTERNATIONAL TECHNIDYNE CORP. L11-01-01RF B8P3C054

Patients

Seq Age Sex Outcome Treatment
1 Other