FDA Adverse Event Injury Summary report: N

INRATIO PT/INR TEST STRIPS

MDR report key: 3962468 · Received July 11, 2014

Report

Report Number
2027969-2014-00651
Event Type
Injury
Date Received
July 11, 2014
Date of Event
June 18, 2014
Report Date
June 20, 2014
Manufacturer
ALERE SAN DIEGO, INC.
Product Code
GJS
PMA / PMN Number
K092987
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING.

Description of Event or Problem · 1

CALLER ALLEGED DISCREPANT LOW INRATIO INR RESULT IN COMPARISON TO A REFERENCE POINT OF CARE (POC) INR RESULT. RESULTS ARE AS FOLLOWS: DATE: (B)(6) 2014, INRATIO INR: 2.9, POC INR: 7.4 AND 7.1. THERAPEUTIC RANGE: 2.5 - 3.0. THE TIME BETWEEN TESTING WAS ONE (1) HOUR. THE PATIENT'S WARFARIN WAS HELD BASED ON THE POC INR. THE FOLLOWING DAY, THE LABORATORY INR WAS 5.4. THERE WAS NO ADDITIONAL INFORMATION PROVIDED. MANUFACTURER REPORT NUMBER 2027969-2014-00651

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
408073 INRATIO PT/INR TEST STRIPS PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100139 344096

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention TOPIRAMATE 150MG IN AM/200MG IN PM| POTASSIUM 20MG| ALLBUTEROL AS NEEDED| COAGUCHECK| WARFARIN 10-12.5MG AS DIRECTED| LANTUS INSULIN 20UNITS| DETROL LA 4MG| DIFLUCAN 1 DOSAGE GIVEN TUESDAY ONLY| SIMVASTATIN 20MG DAILY| METFORMIN 500MG 2X DAILY| DOC-Q-LACEE 200MG| CIPRO 500MG DAILY| DAKTOZIN 20MG 4X DAILY| INRATIO MONITOR, SN 112054458