FDA Adverse Event
Malfunction
Summary report: N
CONTOUR
MDR report key: 2842408
·
Received November 21, 2012
Report
- Report Number
- 1826988-2012-00612
- Event Type
- Malfunction
- Date Received
- November 21, 2012
- Date of Event
- November 1, 2012
- Report Date
- November 1, 2012
- Manufacturer
- BAYER HEALTHCARE LLC
- Product Code
- NBW
- PMA / PMN Number
- K062058
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- KS, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
THE ADVOCATE STATED HER SON TESTED HIS BLOOD GLUCOSE USING HIS CONTOUR METER AND A DIFFERENT METER. HE RECEIVED A 100 MG/DL DIFFERENCE BETWEEN READINGS. DEPENDING ON THE ACTUAL READINGS, THE DIFFERENCE BETWEEN THEM COULD FALL IN THE "C" ZONE OF THE CONSENSUS ERROR GRID, MAKING THE DIFFERENCE CLINICALLY SIGNIFICANT. THERE WAS NO EVIDENCE OF AN ADVERSE EVENT. THE TEST STRIPS ARE TO BE RETURNED FOR EVALUATION. REPLACEMENT TEST STRIPS AND A NEW METER WERE SENT TO THE CUSTOMER.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | CONTOUR | BLOOD GLUCOSE TEST STRIPS | NBW | BAYER HEALTHCARE LLC | 7098B | 2FC3F11 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |