FDA Adverse Event Injury Summary report: N

CONTOUR TEST STRIPS

MDR report key: 2112341 · Received May 27, 2011

Report

Report Number
1826988-2011-00295
Event Type
Injury
Date Received
May 27, 2011
Date of Event
May 1, 2011
Report Date
May 4, 2011
Manufacturer
BAYER HEALTHCARE, LLC
Product Code
NBW
PMA / PMN Number
K062058
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

IN SOME COUNTRIES OUTSIDE THE US, CUSTOMER INFORMATION IS NOT PROVIDED DUE TO PRIVACY LAWS.

Description of Event or Problem · 1

THE ADVOCATE CONTACTED CUSTOMER SERVICE ON BEHALF OF THE CUSTOMER FROM (B)(6). SHE ALLEGED THAT THE CUSTOMER RECEIVED ERRATIC READINGS OF 26 AND 8 MMOL/L USING HIS CONTOUR METER. SHE GAVE HIM INSULIN BASED ON THE HIGH READING AND HE BECAME HYPOGLYCEMIC. THE ADVOCATE TREATED THE CUSTOMER FOR LOW BLOOD GLUCOSE. THE ADVOCATE WAS ADVISED TO RETURN THE TEST STRIPS FOR EVALUATION. REPLACEMENT TEST STRIPS AND A NEW METER WERE SENT TO THE CUSTOMER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CONTOUR TEST STRIPS NBW BAYER HEALTHCARE, LLC NOT PROVIDED 0HC3D04

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention