FDA Adverse Event Injury Summary report: N

CONTOUR

MDR report key: 10976192 · Received December 9, 2020

Report

Report Number
1810909-2020-00643
Event Type
Injury
Date Received
December 9, 2020
Date of Event
November 23, 2020
Report Date
November 23, 2020
Manufacturer
ASCENSIA DIABETES CARE US INC.
Product Code
JJX
PMA / PMN Number
K062058
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

AS PER THE CONTOUR CONTROL SOLUTION SAFETY DATA SHEET, THE MATERIAL IN THE CONTOUR CONTROL SOLUTION IS NOT A HAZARDOUS SUBSTANCE. AS PER THE TOXICOLOGICAL INFORMATION ON THE SAFETY DATA SHEET, THE CONTACT OF THE CONTROL SOLUTION WITH THE EYE MAY CAUSE SLIGHT IRRITATION. IN THE CASE OF CONTACT WITH EYES, THE SAFETY DATA SHEET ADVISES RINSING EYES IMMEDIATELY WITH PLENTY OF WATER AND TO SEEK MEDICAL ADVICE. THE PATIENT/FAMILY WAS THE INITIAL REPORTER, SO PERSONAL INFORMATION WAS NOT ENTERED. NO INFORMATION WAS CAPTURED AS THE CUSTOMER'S INITIALS, AGE, AND WEIGHT WERE NOT PROVIDED. SINCE NO PRODUCT DETAILS WERE PROVIDED, NO INFORMATION WAS CAPTURED (MODEL #, LOT #, AND EXPIRATION DATE), AND THE DEVICE MANUFACTURE DATE COULD NOT BE DETERMINED.

Description of Event or Problem · 1

A CUSTOMER CALLED TO REPORT THAT HE ACCIDENTALLY APPLIED CONTOUR CONTROL SOLUTION TO HIS EYE. THE CUSTOMER DID NOT ALLEGE ANY SERIOUS EFFECTS. NO FURTHER EVENT DETAILS WERE PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1445219 CONTOUR QUALITY CONTROL MATERIAL JJX ASCENSIA DIABETES CARE US INC.

Patients

Seq Age Sex Outcome Treatment
1