FDA Adverse Event Malfunction Summary report: N

INRATIO PT/INR TEST STRIPS

MDR report key: 4152241 · Received October 3, 2014

Report

Report Number
2027969-2014-00906
Event Type
Malfunction
Date Received
October 3, 2014
Date of Event
September 30, 2014
Report Date
September 30, 2014
Manufacturer
ALERE SAN DIEGO, INC.
Product Code
GJS
PMA / PMN Number
K092987
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION/CONCLUSION: IT IS INDICATED THAT PRODUCT IS NOT RETURNING FOR EVALUATION. THEREFORE, INVESTIGATION OF THE COMPLAINT TO DETERMINE ROOT CAUSE CANNOT BE COMPLETED. ROOT CAUSE COULD NOT BE DETERMINED FROM THE INFORMATION PROVIDED BY THE CUSTOMER. SINCE THE PRODUCT ASSOCIATED WITH THE COMPLAINT WAS NOT RETURNED, A REVIEW OF IN-HOUSE TESTING DATA WAS PERFORMED. RETAIN STRIP TESTING RESULTS MET BOTH ACCURACY AND REPEATABILITY CRITERIA. THE PRODUCT PERFORMED AS EXPECTED AND NO PRODUCT DEFICIENCIES WERE OBSERVED. THE MANUFACTURING RECORDS FOR THE LOT WERE REVIEWED. THE LOT MET SPECIFICATIONS AND NO NON-CONFORMANCES WERE DOCUMENTED. NO FURTHER INVESTIGATION WILL BE PURSUED AT THIS TIME. BASED ON THE INFORMATION AVAILABLE, THERE IS NO INDICATION OF A PRODUCT DEFICIENCY. NO CORRECTIVE ACTION IS REQUIRED AT THIS TIME.

Description of Event or Problem · 1

CALLER ALLEGED DISCREPANT LOW INRATIO INR RESULT IN COMPARISON TO LABORATORY INR RESULT. RESULTS ARE AS FOLLOWS: DATE: (B)(6) 2014; INRATIO INR: 1.5; LABORATORY INR: 2.5. THERAPEUTIC RANGE: 2.0 - 3.0. TESTING WAS PERFORMED WITHIN ONE (1) HOUR OF EACH OTHER. THERE WAS NO REPORTED ADVERSE PATIENT SEQUELA. THERE WAS NO ADDITIONAL INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
617284 INRATIO PT/INR TEST STRIPS PROTHROMBIN TIME TEST GJS ALERE SAN DIEGO, INC. 100139 348121

Patients

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