FDA Adverse Event
Malfunction
Summary report: N
TRUERESULT
MDR report key: 3820537
·
Received April 9, 2014
Report
- Report Number
- 1052693-2014-00120
- Event Type
- Malfunction
- Date Received
- April 9, 2014
- Date of Event
- March 19, 2014
- Report Date
- April 9, 2014
- Manufacturer
- NIPRO DIAGNOSTICS INC.
- Product Code
- NBW
- PMA / PMN Number
- K080641
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
(B)(4). PRODUCT NOT YET RETURNED.
Description of Event or Problem · 1
CONSUMER COMPLAINT OF ABOUT HIGH BLOOD RESULTS. CUSTOMER NORMALLY RANGES ABOUT 150 MG/DL 2 HOURS AFTER A MEAL. BASED ON PARKES ERROR GRID ANALYSIS, THE BIAS BETWEEN THE HIGHEST RESULT IN MEMORY (356) AND THE LOWEST NORMAL RESULT (150) IS LOCATED IN ZONE C. NO ADVERSE EVENT REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 213366 | TRUERESULT | BLOOD GLUCOSE SYSTEM | NBW | NIPRO DIAGNOSTICS INC. | TRUERESULT | PP1619 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |