FDA Adverse Event Malfunction Summary report: N

INRATIO

MDR report key: 3243032 · Received July 18, 2013

Report

Report Number
2027969-2013-00582
Event Type
Malfunction
Date Received
July 18, 2013
Date of Event
June 28, 2013
Report Date
July 1, 2013
Manufacturer
ALERE SAN DIEGO, INC.
Product Code
GJS
PMA / PMN Number
K092987
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE IS EXPECTED TO BE RETURNED BUT HAS NOT YET BEEN RECEIVED. INVESTIGATION PENDING.

Description of Event or Problem · 1

CALLER ALLEGED DISCREPANT INRATIO INR RESULT IN COMPARISON TO THE LABORATORY INR RESULT. RESULTS ARE AS FOLLOWS: DATE: (B)(6) 2013; INRATIO INR: 1.8; LABORATORY INR: 6.0. THE TIME BETWEEN TESTING WAS WITHIN ONE HOUR. THERAPEUTIC RANGE 1.5 - 2.5 FOR THE PT. THERE WAS NO REPORTED ADVERSE PT SEQUELA. THERE WAS NO ADDITIONAL INFO PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
335437 INRATIO PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100071 304239

Patients

Seq Age Sex Outcome Treatment
1 COUMADIN| TWO UNSPECIFIED ANTIBIOTICS