FDA Adverse Event
Malfunction
Summary report: N
CONTOUR
MDR report key: 2000494
·
Received January 31, 2011
Report
- Report Number
- 1826988-2011-00036
- Event Type
- Malfunction
- Date Received
- January 31, 2011
- Date of Event
- January 19, 2011
- Report Date
- January 19, 2011
- Manufacturer
- BAYER HEALTHCARE, LLC
- Product Code
- NBW
- PMA / PMN Number
- K062058
- Removal / Correction Number
- NA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MI, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
THE CUSTOMER RECEIVED A BLOOD GLUCOSE READING OF 349 MG/DL FROM HIS CONTOUR METER AND A READING OF 119 MG/DL FROM ANOTHER METER. 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 DURING THE CALL 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 | 9545C | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNK |