FDA Adverse Event Malfunction Summary report: N

SURESTEP

MDR report key: 244894 · Received October 12, 1999

Report

Report Number
2939301-1999-00826
Event Type
Malfunction
Date Received
October 12, 1999
Report Date
September 11, 1999
Manufacturer
LIFESCAN, INC.
Product Code
CGA
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
ME, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

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

Description of Event or Problem · 1

THE REPORTER STATED THAT SHE DID BACK TO BACK BLOOD GLUCOSE TESTING, WITHIN 10 MINUTES, USING SEPARATE FINGER STICKS. HER RESULTS WERE 338, 141, 135 AND 131 MG/DL. SHE DID NOT HAVE ANY SYMPTOMS. THE REPORTER'S CONTROL SOLUTION WAS EXPIRED, AND SHE DID NOT HAVE TEST STRIPS AVAILABLE FOR CONTROL TESTING. SHE IS FAMILIAR WITH CODING, CONTROL, AND THE LIFESCAN REPRESENTATIVE REVIEWED CLEANING. THE REPORTER WILL CALL BACK IF FURTHER PROBLEMS AFTER RECEIVING NEW SUPPLIES.

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 44 YR Other