FDA Adverse Event Malfunction Summary report: N

SURESTEP

MDR report key: 247813 · Received October 29, 1999

Report

Report Number
2939301-1999-00944
Event Type
Malfunction
Date Received
October 29, 1999
Report Date
October 8, 1998
Manufacturer
LIFESCAN, INC.
Product Code
CGA
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE REPORTER STATED THAT HIS SON HAD DONE A BG METER TEST ON HIM AND RECEIVED AN ER1 MESSAGE. HE SAID HE WENT TO THE HOSP BECAUSE HE WAS NOT FEELING WELL AND HIS BG WAS >500 MG/DL. THE REPORTER STATED THAT HE HAS NO SHORT TERM MEMORY AND DOES NOT KNOW HOW TO CONTACT HIS SON. HIS STATEMENTS WERE INCONSISTENT. HE GAVE THE METER MEMORY ON 10/8/1998 AS 145, 191, 167, 190, 213, 134, 318, 160, 130, AND 154. ON FOLLOW UP, A CONTROL SOLUTION RESULT WAS IN RANGE, (126) 89-133. NO FURTHER INFO WAS PROVIDED. NO HARM WAS ALLEGED.

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 UNKNOWN Other