FDA Adverse Event Malfunction Summary report: N

SURESTEP

MDR report key: 275826 · Received April 26, 2000

Report

Report Number
2939301-2000-00322
Event Type
Malfunction
Date Received
April 26, 2000
Report Date
March 29, 2000
Manufacturer
LIFESCAN, INC.
Product Code
CGA
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE RPTR STATED THAT RPTR DID BACK TO BACK BLOOD GLUCOSE TESTS, WITH DIFFERENCE OF 100-200 MG/DL. RPTR'S SPOUSE ASSISTS THE RPTR (RPTR HAS PARKINSONS AND ALZHEIMERS) WITH RPTR'S TESTING. ON FOLLOW UP, SPOUSE GAVE THE RESULTS OF THE SUBJECT TESTS, DONE WITHIN 1 MINUTE OF EACH OTHER, AS 230, 167 AND 135 MG/DL. RPTR DID NOT HAVE ANY SYMPTOMS. SPOUSE STATED THAT SPOUSE PUT 2-3 DROPS OF BLOOD ONTO THE TEST STRIP. 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 79 YR Other