FDA Adverse Event Other Summary report: N

PTS PANELS GLUCOSE TEST STRIPS

MDR report key: 1365042 · Received April 16, 2009

Report

Report Number
1836135-2009-00001
Event Type
Other
Date Received
April 16, 2009
Date of Event
January 14, 2009
Report Date
April 15, 2009
Manufacturer
POLYMER TECHNOLOGY SYSTEMS, INC.
Product Code
CGA
PMA / PMN Number
010368
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

A CUSTOMER REPORTED HAVING IN THEIR POSSESSION A VIAL OF PTS PANELS/CARDIOCHEK GLUCOSE STRIPS WHICH HAD A PRIMARY (IMMEDIATE) VIAL LABEL OF LOT (B)(4), EXPIRATION DATE 2010-01-14 AND AN OUTER BOX LABEL OF P821, EXPIRATION DATE 2009-08-20. THE LOT NUMBER ON THE PRIMARY VIAL BEARING THE U (B)(4) IS THE CORRECT CITATION FOR A CARDIOCHEK GLUCOSE MATERIAL. THE MEMO CHIP CONTAINED WITHIN THE BOX, WHICH PROVIDES THE SPECIFIC ANALYTE CONVERSION CURVE (FROM THE INSTRUMENT REFLECTANCE READING) WHICH THE CARDIOCHEK USES TO DISPLAY THE RESULT OF A TEST WAS THE CORRECT (B)(4) MEMO CHIP. AN INTERNAL INVESTIGATION DEMONSTRATED A LIKELY VERY LOW INCIDENCE OF THIS MISLABELED PRODUCT. THE PRIMARY LABEL IS CORRECT AND THE MEMO CHIP WHICH DICTATES GLUCOSE RESULTS DISPLAY WAS CORRECT. THUS THERE IS NO ADVERSE USER CONSEQUENCE RESULTING FROM THE MISLABELING AND THERE IS NO MEDICAL OR HEALTH RISK. FURTHERMORE, THE PRODUCT IMPACT IS THAT AFTER (B)(6) 2009, THE OUTSIDE LABEL WOULD LEAD THE USER TO THINK THE PRODUCT WAS OUT OF DATE WHEN INDEED IT REMAINED WITHIN EXPIRATION DATE. THIS MEDWATCH IS BEING REPORTED TO ALERT POTENTIAL USERS OF THIS MISLABELING WHICH HAS NO PERFORMANCE IMPACT OR ADVERSE HEALTH EFFECT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PTS PANELS GLUCOSE TEST STRIPS GLUCOSE TEST SYSTEM CGA POLYMER TECHNOLOGY SYSTEMS, INC. U851

Patients

Seq Age Sex Outcome Treatment
1