FDA Adverse Event Malfunction Summary report: N

SURESTEP

MDR report key: 251307 · Received November 18, 1999

Report

Report Number
2939301-1999-00974
Event Type
Malfunction
Date Received
November 18, 1999
Report Date
October 19, 1999
Manufacturer
LIFESCAN, INC.
Product Code
CGA
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KS, 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 HE DID BACK TO BACK BLOOD GLUCOSE TESTS, WITHIN 10 MINUTES, USING SEPARATE FINGER STICKS. HIS RESULTS WERE 203, 171, 117 MG/DL. HE DID NOT HAVE ANY SYMPTOMS. CONTROL TESTING WAS NOT DONE DUE TO LACK OF SUPPLIES. ON FOLLOW UP, THE REPORTER STATED HE HAD DONE A CONTROL TEST WITH A RESULT OF 123 MG/DL, WHICH WAS IN RANGE. THE LIFESCAN REPRESENTATIVE REVIEWED COVERAGE, CLEANING, CODING AND STORAGE WITH THE REPORTER.

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 75 YR Other