FDA Adverse Event
Malfunction
Summary report: N
BREEZE2 TEST STRIPS
MDR report key: 2213857
·
Received August 4, 2011
Report
- Report Number
- 1826988-2011-00454
- Event Type
- Malfunction
- Date Received
- August 4, 2011
- Date of Event
- July 16, 2011
- Report Date
- July 16, 2011
- Manufacturer
- BAYER HEALTHCARE, LLC
- Product Code
- NBW
- PMA / PMN Number
- K062347
- Removal / Correction Number
- NA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NY, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
THE ADVOCATE STATED THE CUSTOMER'S BREEZE2 METER GAVE BLOOD GLUCOSE READINGS OF 210 AND 275 MG/DL, WHILE ANOTHER METER READ 105 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 ADVOCATE ALSO PERFORMED CONTROL TESTS DURING THE CALL AND RECEIVED RESULTS OF 168 AND 194 MG/DL. THE NORMAL CONTROL RANGE WAS 99-127 MG/DL. 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 | BREEZE2 TEST STRIPS | NBW | BAYER HEALTHCARE, LLC | 1465A | 1A5886AA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNK |