Investigation conclusion: lot 050726c was manufactured prior to 2007.A review of the available historical documents did not uncover any information that the lot was notable in its performance.Due to the age of the product, no additional investigation can be performed.Alere has withdrawn the alere inratio®/inratio®2 pt/inr system from the market and is no longer manufacturing alere inratio® test strips and monitors.In addition, all alere inratio® test strips are now expired.Further investigation is not possible at this time.Based on the information available, there is no indication of a product deficiency and no corrective action is required.
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The patient initially called in response to the inratio withdrawal notification.The patient reported using the inratio system between 2007 and 2009.During this time, the patient experienced correlation and precision issues on three inratio monitors for two lots of inratio test strips (refer to case mdr 2027969-2018-00083 for alternate lot number).The patient's therapeutic range was 2.0-3.0.The patient stated that the inratio inr results varied by 20% (both high and low) as compared to the laboratory.Additionally, the patient would test multiple times in a row on the same monitor and across the other monitors and the inratio inr results would vary.The patient reported that the prescribed warfarin dosage may have been adjusted based on the inratio inr results but cannot recall the dosage changes or whether the laboratory inr results influenced these changes.The patient confirmed that no adverse outcomes occurred.The patient discontinued use of the inratio system in 2009.The patient stated that he performed troubleshooting by testing a female non-coumadin user.The patient expected to receive an inr of 1.0 but "the results were also all over the place" while using the same three inratio monitors and two lot numbers.
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