FDA Adverse Event Malfunction Summary report: N

TRUE METRIX PRO

MDR report key: 18055047 · Received November 2, 2023

Report

Report Number
1000113657-2023-00537
Event Type
Malfunction
Date Received
November 2, 2023
Date of Event
October 11, 2023
Report Date
November 2, 2023
Manufacturer
TRIVIDIA HEALTH INC
Product Code
NBW
UDI-DI
00021292007867
PMA / PMN Number
K140100
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

INTERNAL REPORT REFERENCE NUMBER: (B)(4). ADDITIONAL REPORT REFERENCE NUMBER: (B)(4). B2: ADVERSE EVENT REPORT IS BEING SUBMITTED DUE TO CUSTOMER GOING TO CLINIC (PHARMACY) DUE TO METER RESULTS AND ERROR MESSAGES. METER WAS RETURNED FOR EVALUATION. PRODUCT TESTING WAS PERFORMED AND NO DEFECT FOUND ON RETURNED METER. TEST STRIPS WERE RETURNED - MIXED LOT, UNABLE TO TEST. RETENTION TESTING WAS PERFORMED USING TEST STRIPS FROM THE SAME LOT. RETENTION STRIP LOT TESTED WITHIN SPECIFICATIONS. MOST LIKELY UNDERLYING ROOT CAUSE: MLC-009: USE ERROR CAUSED OR CONTRIBUTED TO EVENT. NOTE: MANUFACTURER CONTACTED CUSTOMER IN A FOLLOW-UP CALL ON 01-NOV-2023 TO ENSURE THE REPLACEMENT PRODUCTS RESOLVED THE INITIAL CONCERN - ABLE TO ESTABLISH CONTACT WITH CUSTOMER WHO STATED REPLACEMENT PRODUCTS RESOLVED INITIAL CONCERN.

Description of Event or Problem · 0

CONSUMER REPORTED COMPLAINT FOR HIGH AND ERRATIC BLOOD GLUCOSE TEST RESULTS AND ERROR MESSAGES (E-0, E-4 AND E-6) USING TWO DIFFERENT VIALS OF TEST STRIPS; INTERNAL REPORT REFERENCE (B)(4). CUSTOMER IS USING TRUE METRIX PRO PRODUCTS WHICH ARE DESIGNED FOR PROFESSIONAL USE. CUSTOMER STATED HE IS UNABLE TO DETERMINE WHICH RESULTS HE OBTAINED USING EACH VIAL. THE CUSTOMER IS CONCERNED WITH TEST RESULTS FROM RESULTS OBTAINED OF 202, 223, 214 AND 250 MG/DL. THE CUSTOMER¿S EXPECTED AM FASTING BLOOD GLUCOSE TEST RESULT IS <130 MG/DL AND EXPECTED PM FASTING BLOOD GLUCOSE TEST RESULT RANGE IS 140-160 MG/DL. THE CUSTOMER FEELS WELL AND DID NOT REPORT ANY SYMPTOMS. CUSTOMER STATED THAT DUE TO THE METER RESULTS AND ERROR MESSAGES HE HAD GONE THAT MORNING (B)(6) 2023 TO THE CLINIC (PHARMACY). CUSTOMER STATED THE PHARMACIST HAD ATTEMPTED TO ASSIST BUT HAD THEN ADVISED THE CUSTOMER TO CONTACT THE MANUFACTURER. DURING THE CALL, A BACK TO BACK BLOOD TEST WAS NOT PERFORMED BY THE CUSTOMER. THE PRODUCT IS STORED ACCORDING TO SPECIFICATION IN THE LIVING ROOM. THE TEST STRIP LOT MANUFACTURER¿S EXPIRATION DATE IS 03/31/2025 AND TEST STRIPS WERE OPENED 1-2 WEEKS PRIOR TO CALL. THE METER MEMORY WAS REVIEWED FOR PREVIOUS TEST RESULT HISTORY (DATE/TIME NOT SET): RESULT 1: 202 MG/DL, DATE: (B)(6), TIME: 6:15AM, FASTING AM ON (B)(6) 2023. RESULT 2: 223 MG/DL, DATE: (B)(6), TIME: 6:14AM, FASTING AM ON (B)(6) 2023. RESULT 3: 214 MG/DL, DATE: (B)(6), TIME: 8:22PM, FASTING PM ON (B)(6) 2023. RESULT 4: 250 MG/DL, DATE: (B)(6), TIME: 8:21PM, FASTING PM ON (B)(6) 2023. RESULT 5: 145 MG/DL, DATE: 10/07, TIME: 8:35PM, FASTING PM ON (B)(6) 2023.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1852013 TRUE METRIX PRO SYSTEM, TEST BLOOD GLUCOSE, OVER THE COUNTER NBW TRIVIDIA HEALTH INC STRIP, TRUE METRIX PRO50CT MG/DL ZB5393S 00021292007867

Patients

Seq Age Sex Outcome Treatment
1 Unknown Other