FDA Adverse Event Other Summary report: N

NOVA MAX GLUCOSE MONITOR

MDR report key: 2222605 · Received August 12, 2011

Report

Report Number
3004193489-2011-00077
Event Type
Other
Date Received
August 12, 2011
Date of Event
August 1, 2011
Report Date
August 12, 2011
Manufacturer
NOVA BIOMEDICAL CORP.
Product Code
NBW
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

NOVA BIOMEDICAL AWAITS THE RETURN OF THE DEVICE FOR EVAL. SHOULD ANY SIGNIFICANT FINDINGS BE A RESULT OF THAT INVESTIGATION, A FOLLOW-UP REPORT WILL BE FILED.

Description of Event or Problem · 1

IT WAS REPORTED TO NOVA BIOMEDICAL THAT A CONSUMER EXPERIENCED A HYPOGLYCEMIC EVENT REQUIRING MEDICAL INTERVENTION. THE CONSUMER'S DAUGHTER WAS UNABLE TO PROVIDE ANY INFO REGARDING THIS EVENT. THIS IS BEING REPORTED AS AN ADVERSE EVENT UNDER THE FDA MEDWATCH REGULATIONS. THE METER AND TEST STRIPS REPORTED IN THIS EVENT WILL NOT BE RETURNED FOR EVALUATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NOVA MAX GLUCOSE MONITOR GLUCOSE MONITOR NBW NOVA BIOMEDICAL CORP. NA 1020210305

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention