BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    FASTTAKE

    MDR report key: 385979 · Received February 11, 2002

    Report

    Report Number
    2939301-2002-02597
    Event Type
    Malfunction
    Date Received
    February 11, 2002
    Report Date
    January 23, 2002
    Manufacturer
    LIFESCAN, INC.
    Product Code
    CFR
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    A PT REPORTED EXPERIENCING INACCURATE ERRATIC RESULTS WITH A FAST TAKE METER. THE PT'S BLOOD GLUCOSE RESULTS WERE 233, 196, 119, 160, 146, 282 AND 126 MG/DL. TESTS WERE DONE WITHIN 10 MINUTES. PT DID NOT EXPERIENCE ANY ADVERSE EVENTS. NO FURHTER INFO HAS BEEN REPORTED.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1 58 YR