FDA Adverse Event Malfunction Summary report: N

INRATIO PT/INR TEST STRIPS

MDR report key: 3884165 · Received May 19, 2014

Report

Report Number
2027969-2014-00451
Event Type
Malfunction
Date Received
May 19, 2014
Date of Event
April 17, 2014
Report Date
April 28, 2014
Manufacturer
ALERE SAN DIEGO INC
Product Code
GJS
PMA / PMN Number
K092987
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 LOW INRATIO INR RESULT IN COMPARISON TO THE LABORATORY INR RESULT AND PHYSICIAN INRATIO INR RESULT. RESULTS ARE AS FOLLOWS: DATE: (B)(6) 2014, INRATIO INR: 1.6, LABORATORY INR: 3.7, PHYSICIANS INRATIO INR: 2.2. THE TIME BETWEEN TESTING WAS TEN (10) MINUTES. REPORTEDLY, MULTIPLE FINGER STICKS PERFORMED ON THE SAME FINGER AND THE SAMPLE WAS NOT APPLIED IMMEDIATELY AFTER THE FINGER STICK. THERAPEUTIC RANGE 2.0 -3.0 FOR THE PT. THERE WAS NO ADVERSE EVENT REPORTED. THERE WAS NO ADD'L INFO PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
295582 INRATIO PT/INR TEST STRIPS PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO INC 100071 315105

Patients

Seq Age Sex Outcome Treatment
1 UNSPECIFIED HBP MEDICATION| INRATIO MONITOR SN: (B)(4)| MULTIVITAMIN,| CALCIUM| UNSPECIFIED ANTIBIOTICS.| LEVOTHYROXINE| VITAMINS AND/OR SUPPLEMENT CENTRUM SILVER 50+| WARFARIN