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