BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TRUERESULT

    MDR report key: 3231773 · Received July 15, 2013

    Report

    Report Number
    1052693-2013-00134
    Event Type
    Malfunction
    Date Received
    July 15, 2013
    Date of Event
    July 4, 2013
    Report Date
    July 15, 2013
    Manufacturer
    NIPRO DIAGNOSTICS, INC.
    Product Code
    NBW
    PMA / PMN Number
    K080641
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, 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 LOW BLOOD GLUCOSE RESULTS. RESULTS IN MEMORY INDICATED A RESULT OF 72 MG/DL ON (B)(6) 2013 AT 12:45 PM. CALLER STATES HIS GLUCOSE IS NORMALLY 125 MG/DL - 135 MG/DL. NO ADVERSE EVENT REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    327808 TRUERESULT BLOOD GLUCOSE SYSTEM NBW NIPRO DIAGNOSTICS, INC. TRUERESULT PP1302

    Patients

    Seq Age Sex Outcome Treatment
    1