FDA Adverse Event Malfunction Summary report: N

TRUE METRIX

MDR report key: 21667943 · Received March 21, 2025

Report

Report Number
1000113657-2025-00098
Event Type
Malfunction
Date Received
March 21, 2025
Date of Event
February 26, 2025
Report Date
March 21, 2025
Manufacturer
TRIVIDIA HEALTH INC
Product Code
NBW
UDI-DI
00021292007836
PMA / PMN Number
K140100
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

INTERNAL REPORT REFERENCE NUMBER: (B)(4). METER WAS RETURNED - REPORTED DEFECT NOT REPRODUCED ON RETURNED METER. TEST STRIPS WERE NOT RETURNED FOR EVALUATION. RETENTION TESTING WAS PERFORMED USING TEST STRIPS FROM THE SAME LOT. RETENTION STRIP LOT TESTED WITHIN SPECIFICATIONS. MOST LIKELY UNDERLYING ROOT CAUSE: MLC-062: USER HAD POOR TECHNIQUE. NOTE: MANUFACTURER CONTACTED CUSTOMER IN SEVERAL FOLLOW-UP CALLS TO ENSURE THE REPLACEMENT PRODUCTS RESOLVED THE INITIAL CONCERN - UNABLE TO ESTABLISH CONTACT WITH CUSTOMER AT THIS TIME.

Description of Event or Problem · 0

CONSUMER REPORTED COMPLAINT FOR HIGH AND ERRATIC BLOOD GLUCOSE TEST RESULTS. THE CUSTOMER IS CONCERNED WITH TEST RESULTS FROM RESULTS OBTAINED OF 146, 101, 129 AND 183 MG/DL. THE CUSTOMER¿S EXPECTED BLOOD GLUCOSE TEST RESULT RANGES ARE 100-115 MG/DL AM FASTING AND <145 MG/DL PM FASTING. THE CUSTOMER FEELS WELL AND DID NOT REPORT ANY SYMPTOMS. MEDICAL ATTENTION IS NOT REPORTED AS A RESULT OF THE ACTUAL BLOOD GLUCOSE RESULTS. DURING THE CALL, A BACK-TO-BACK BLOOD TEST WAS NOT PERFORMED BY THE CUSTOMER. THE PRODUCT IS STORED ACCORDING TO SPECIFICATION IN THE BEDROOM. THE TEST STRIP LOT MANUFACTURER¿S EXPIRATION DATE IS 07/24/2026 AND OPEN VIAL DATE IS A WEEK AGO. THE METER MEMORY WAS REVIEWED FOR PREVIOUS TEST RESULT HISTORY: RESULT 1: 145MG/DL DATE: (B)(6), TIME: 5:52PM FASTING. RESULT 2: 136MG/DL DATE: (B)(6), TIME: 1:06PM FASTING. RESULT 3: 146MG/DL DATE: (B)(6), TIME: 1:05PM FASTING. RESULT 4: 101MG/DL DATE: (B)(6), TIME: 10:05AM FASTING. RESULT 5: 129MG/DL DATE: (B)(6), TIME: 9:56AM FASTING. RESULT 6: 183MG/DL DATE: (B)(6), TIME: 9:55AM FASTING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1233500 TRUE METRIX SYSTEM, TEST BLOOD GLUCOSE, OVER THE COUNTER NBW TRIVIDIA HEALTH INC STRIP, LEADER TMX 100CTMG/DL ZC5937S 00021292007836

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown