FDA Adverse Event Malfunction Summary report: N

CNRATIO2 PT/INR PROFESSIONAL TEST STRIP

MDR report key: 3972866 · Received April 28, 2014

Report

Report Number
2027969-2014-00375
Event Type
Malfunction
Date Received
April 28, 2014
Date of Event
April 7, 2014
Report Date
April 8, 2014
Manufacturer
ALERE SAN DIEGO, INC.
Product Code
GJS
PMA / PMN Number
K110212
Removal / Correction Number
2027969-04/16/14-001-R
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING.

Description of Event or Problem · 1

CALLER ALLEGED DISCREPANT HIGH INRATIO2 INR RESULT IN COMPARISON TO THE LABORATORY INR RESULT. RESULTS ARE AS FOLLOWS: DATE: (B)(6) 2014, INRATIO2 INR: 7.2, LABORATORY INR: 2.2, THERAPEUTIC RANGE: 2.0-3.0. THE TIME BETWEEN TESTING WAS WITHIN MINUTES. THERE WAS NO REPORTED ADVERSE PT SEQUELA. THERE WAS NO ADD'L INFO PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
253487 CNRATIO2 PT/INR PROFESSIONAL TEST STRIP PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 99008G2 336426

Patients

Seq Age Sex Outcome Treatment
1 INRATIO MONITOR SN #: (B)(4)| COUMADIN