FDA Adverse Event
Malfunction
Summary report: N
CONTOUR
MDR report key: 1900009
·
Received November 8, 2010
Report
- Report Number
- 1826988-2010-00756
- Event Type
- Malfunction
- Date Received
- November 8, 2010
- Date of Event
- October 1, 2010
- Report Date
- October 21, 2010
- Manufacturer
- BAYER HEALTHCARE, LLC
- Product Code
- NBW
- PMA / PMN Number
- K060470
- Removal / Correction Number
- NA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NY, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Description of Event or Problem · 1
THE CUSTOMER TESTED HIS BLOOD GLUCOSE USING HIS CONTOUR METERS AND RECEIVED READINGS OF 106 AND 67 MG/DL. THE DIFFERENCE BETWEEN THE READINGS FALLS IN THE "C" ZONE OF THE CONSENSUS ERROR GRID, MAKING THE DIFFERENCE CLINICALLY SIGNIFICANT. NO ADVERSE EVENT WAS ALLEGED. THE CUSTOMER PERFORMED CONTROL TESTS WHILE TROUBLESHOOTING AND THE RESULTS FELL WITHIN THE NORMAL CONTROL RANGE. NO PRODUCT WILL BE RETURNED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | CONTOUR | NBW | BAYER HEALTHCARE, LLC | 7151A | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNK |