FDA Adverse Event
Malfunction
Summary report: N
TRUETRACK
MDR report key: 3036867
·
Received March 29, 2013
Report
- Report Number
- 1052693-2013-00033
- Event Type
- Malfunction
- Date Received
- March 29, 2013
- Date of Event
- March 5, 2013
- Report Date
- March 29, 2013
- Manufacturer
- NIPRO DIAGNOSTICS, INC.
- Product Code
- NBW
- PMA / PMN Number
- K032657
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
PRODUCT NOT YET RETURNED FOR EVALUATION. (B)(4).
Description of Event or Problem · 1
CONSUMER COMPLAINT OF HIGH CONTROL RESULTS. CONTROL TEST RESULTS WERE 231 MG/DL AND 241 MG/DL FOR A CONTROL RANGE OF 153-207 MG/DL. CONTROL TEST RESULT WAS 218 MG/DL USING A SECOND VIAL OF STRIPS FROM THE SAME LOT. NO ADVERSE EVENT REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 131316 | TRUETRACK | BLOOD GLUCOSE SYSTEM | NBW | NIPRO DIAGNOSTICS, INC. | TRUETRACK | RN4068 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |