FDA Adverse Event
Malfunction
Summary report: N
CONTOUR
MDR report key: 3811999
·
Received May 15, 2014
Report
- Report Number
- 1826988-2014-00171
- Event Type
- Malfunction
- Date Received
- May 15, 2014
- Date of Event
- April 1, 2014
- Report Date
- April 24, 2014
- Manufacturer
- BAYER HEALTHCARE LLC
- Product Code
- NBW
- PMA / PMN Number
- K062058
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- WV, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
THE CUSTOMER RECEIVED A BLOOD GLUCOSE READING OF 180MG/DL ON THE CONTOUR METER, RE-TESTED ON A DIFFERENT METER AND THE READING WAS 90MG/DL. THE DIFFERENCE BETWEEN THE READINGS FALLS IN THE "C" ZONE OF THE CONSENSUS ERROR GRID, MAKING THE DIFFERENCE CLINICALLY SIGNIFICANT.NO ADVERSE EVENT WAS ALLEGED.THE CUSTOMER WAS ADVISED TO RETURN THE TEST STRIPS FOR EVALUATION.A NEW KIT SENT TO THE CUSTOMER.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 290181 | CONTOUR | BLOOD GLUCOSE TEST STRIPS | NBW | BAYER HEALTHCARE LLC | 7097C | 3JJ3F03 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |