FDA Adverse Event Injury Summary report: N

INRATIO PT/INR TEST STRIPS

MDR report key: 4060296 · Received August 25, 2014

Report

Report Number
2027969-2014-00777
Event Type
Injury
Date Received
August 25, 2014
Date of Event
August 3, 2014
Report Date
August 4, 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
NJ, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION PENDING.

Description of Event or Problem · 1

CALLER ALLEGED DISCREPANT LOW INRATIO INR RESULT IN COMPARISON TO THE LAB INR RESULT. RESULTS ARE AS FOLLOWS: DATE: (B)(6) 2014, INRATIO INR: 2.4, LAB INR: 12.5. THERAPEUTIC RANGE: 2.0 - 3.0. THE TIME BETWEEN TESTING WAS AT LEAST TWO (2) HOURS. REPORTEDLY, THE PT WAS EXPERIENCING SIGNIFICANT BRUISING ON LEGS AND BLEEDING FROM THE MOUTH ON (B)(6) 2014. PT WAS SEEN IN THE EMERGENCY ROOM WHERE THE LAB INR WAS 12.5. THE PT WAS HOSPITALIZED WITH HIGH INR, EXCESSIVE BRUISING AND BLEEDING. THOUGH REQUESTED, NO ADD'L INFO WAS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
513572 INRATIO PT/INR TEST STRIPS PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100139 344683

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization INRATIO MONITOR: SN (B)(4)| WARFARIN 3MG DAILY