BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    FASTTAKE

    MDR report key: 367181 · Received December 17, 2001

    Report

    Report Number
    2939301-2001-01438
    Event Type
    Malfunction
    Date Received
    December 17, 2001
    Report Date
    November 7, 2001
    Manufacturer
    LIFESCAN, INC.
    Product Code
    CFR
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    A PATIENT REPORTED EXPERIENCED INACCURATE ERRATIC RESULTS WITH A FAST TAKE METER. THE PATIENT'S BLOOD GLUCOSE RESULTS WERE 120, 220 AND 320 MG/DL. TEST WERE DONE WITHIN 10 MINUTES. PATIENT DID NOT EXPERIENCE ANY ADVERSE EVENTS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    56991 FASTTAKE BLOOD GLUCOSE MONITORING KIT/SYSTEM CFR LIFESCAN, INC. NA NA

    Patients

    Seq Age Sex Outcome Treatment
    1 24 YR