FDA Adverse Event Other Summary report: N

ONE TOUCH ULTRA

MDR report key: 375764 · Received January 30, 2002

Report

Report Number
2939301-2002-00997
Event Type
Other
Date Received
January 30, 2002
Report Date
October 5, 2001
Manufacturer
LIFESCAN, INC.
Product Code
CFR
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

METER NAME: ONE TOUCH ULTRA, STRIP NAME: LIFESCAN OT ULTRA, METER CODE: UNK. STRIP CODE: UNK. STRIP STORAGE: UNK. SYMPTOMS ARE: NONE. A PT REPORTED THAT THEIR MEDICATION WAS CHANGED DUE TO LOW READINGS ON METER. CUSTOMER WAS UNAWARE THAT THEIR METER WAS SET IN MMOL/L. PT'S METER ALLEGEDLY HAD AN APPLY SAMPLE MESSAGE. THE RESULT ON THEIR METER WAS 5.2MMOL. THE RESULT ON THE ER METER WAS 171MG/DL. THE TIME DIFFERENCE BETWEEN PT'S METER AND ER METER WAS 3 HRS. CUSTOMER DID NOT RECEIVE ANY TREATMENT. BUT SINCE PT'S 5.2MMOL/L READING WAS INTERPRETED AS 52MG/DL, PT'S MEDICATION DOSAGE WAS CHANGED. NO FURTHER INFO HAS BEEN REPORTED.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 63 YR Hospitalization