FDA Adverse Event
Malfunction
Summary report: N
CONTOUR TS TEST STRIPS
MDR report key: 2213799
·
Received August 4, 2011
Report
- Report Number
- 1826988-2011-00452
- Event Type
- Malfunction
- Date Received
- August 4, 2011
- Date of Event
- July 14, 2011
- Report Date
- July 14, 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
- NC, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
THE CUSTOMER CALLED FOR HELP WITH HER CONTOUR TS METER. SHE PERFORMED CONTROL TESTS DURING THE CALL AND RECEIVED A RESULT OF 386 MG/DL. THE NORMAL CONTROL RANGE WAS 99-137 MG/DL. NO ADVERSE EVENTS WERE ALLEGED. THE TEST STRIPS ARE TO BE RETURNED 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 TS TEST STRIPS | NBW | BAYER HEALTHCARE LLC | 1820 | 1AD3E03 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNK |