BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ONE TOUCH BASIC ORIGINAL

    MDR report key: 370303 · Received December 21, 2001

    Report

    Report Number
    2939301-2001-01594
    Event Type
    Malfunction
    Date Received
    December 21, 2001
    Report Date
    November 16, 2001
    Manufacturer
    LIFESCAN, INC.
    Product Code
    CFR
    Removal / Correction Number
    NA
    Report Source
    Manufacturer report
    Reporter Location
    MI, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    A PATIENT REPORTED EXPERIENCING INACCURATE ERRATIC RESULTS WITH A ONE TOUCH BASIC METER. THE PATIENT'S BLOOD GLUCOSE RESULTS WERE 193, 104, 185, AND 162 MG/DL. TESTS WERE DONE LESS THAN 10 MINUTES APART. NO FURTHER INFORMATION HAS BEEN REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    58017 ONE TOUCH BASIC ORIGINAL BLOOD GLUCOSE MONITORING KIT/SYSTEM CFR LIFESCAN, INC. NA NA

    Patients

    Seq Age Sex Outcome Treatment
    1 35 YR