FDA Adverse Event Other Summary report: N

TRUERESULT

MDR report key: 3472032 · Received November 4, 2013

Report

Report Number
1052693-2013-00138
Event Type
Other
Date Received
November 4, 2013
Date of Event
April 16, 2013
Report Date
June 28, 2013
Manufacturer
NIPRO DIAGNOSTICS, INC.
Product Code
NBW
PMA / PMN Number
K080710
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). COMMUNICATIONS TO CUSTOMER (PHONE, MAIL) WERE NOT RETURNED. UNABLE TO GET PRODUCT BACK OR OBTAIN MORE INFO.

Description of Event or Problem · 1

RECEIVED INITIAL EMAIL FROM (B)(6) CLAIMS MANAGEMENT COMPANY THAT A CUSTOMER (B)(6) HAS FILED A CLAIM FOR MEDICAL ATTENTION HE NEEDED IN (B)(6) 2012, DUE TO A METER AND TEST STRIPS DISPLAYING INCORRECT READINGS. CUSTOMER DID SEEK MEDICAL ATTENTION AT THE HOSPITAL. NO FURTHER INFO RECEIVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
565842 TRUERESULT BLOOD GLUCOSE SYSTEM NBW NIPRO DIAGNOSTICS, INC. TRUERESULT UNK

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization