FDA Adverse Event Death Summary report: N

TRUTRACK

MDR report key: 2340345 · Received November 14, 2011

Report

Report Number
1052693-2011-00062
Event Type
Death
Date Received
November 14, 2011
Date of Event
October 17, 2011
Report Date
November 14, 2011
Manufacturer
NIPRO DIAGNOSTICS, INC.
Product Code
CGA
PMA / PMN Number
K032657
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
PHARMACIST

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

COMPLAINT OF INACCURATE RESULTS REPORTED BY A CONSUMER THROUGH (B)(6) PHARMACY. CONSUMER'S RELATIVE CLAIMS INACCURATE RESULTS LED TO IMPROPER MEDICATION RESULTING IN DEATH. PT WAS A TYPE I DIABETIC.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TRUTRACK BLOOD GLUCOSE SYSTEM CGA NIPRO DIAGNOSTICS, INC. TRUETRACK RM3539

Patients

Seq Age Sex Outcome Treatment
1 Death