BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    METER C - OT PROFILE

    MDR report key: 365286 · Received December 6, 2001

    Report

    Report Number
    2939301-2001-01198
    Event Type
    Malfunction
    Date Received
    December 6, 2001
    Report Date
    October 25, 2001
    Manufacturer
    LIFESCAN, INC.
    Product Code
    CFR
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    LA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    A PT REPORTED EXPERIENCING INACCURAT ERRATIC RESULTS WITH A OT PROFILE METER. THE PT'S BLOOD GLUCOSE WAS 250, 298, 451 MG/DL WITHIN 10 MINUTES, WITH A DIFFERENCE OF 36%. PT DID NOT EXPERIENCE ANY ADVERSE EVENTS. NO FURTHER INFO HAS BEEN REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    55018 METER C - OT PROFILE BLOOD GLUCOSE MONITORING KIT/SYSTEM CFR LIFESCAN, INC. NA NA

    Patients

    Seq Age Sex Outcome Treatment
    1 73 YR