FDA Adverse Event Malfunction Summary report: N

SURESTEP

MDR report key: 241175 · Received September 15, 1999

Report

Report Number
2939301-1999-00745
Event Type
Malfunction
Date Received
September 15, 1999
Report Date
August 16, 1999
Manufacturer
LIFESCAN, INC.
Product Code
CGA
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

METER WAS NOT THE SUBJECT OF FDA RECALL Z-631-8

Description of Event or Problem · 1

THE RPTR DID TWO SETS OF BACK TO BACK BLOOD GLUCOSE TESTS. THE FIRST SET OF TESTS RESULTED IN 190, 180 AND 140 MG/DL. THE SECOND SET OF TESTS WERE FROM HIS NON-DIABETIC WIFE AND HER READINGS WERE 110 AND 60 MG/DL. TESTS WERE DONE WITHIN 10 MINS OF EACH OTHER, USING THE SAME FINGERSTICK A COUPLE OF TIMES. THERE WERE NO SYMPTOMS. HE DID NOT HAVE ANY CONTROL SOLUTION FOR TESTING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SURESTEP BLOOD GLUCOSE MONITORING KIT/SYSTEM CGA LIFESCAN, INC. NA NA

Patients

Seq Age Sex Outcome Treatment
1 57 YR Other