FDA Adverse Event Malfunction Summary report: N

TRUETRACK

MDR report key: 4110117 · Received September 11, 2014

Report

Report Number
1052693-2014-00305
Event Type
Malfunction
Date Received
September 11, 2014
Date of Event
July 31, 2014
Report Date
January 7, 2016
Manufacturer
NIPRO DIAGNOSTICS, INC.
Product Code
NBW
PMA / PMN Number
K032657
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). MOST LIKELY UNDERLYING ROOT CAUSE OF MALFUNCTION USER MECHANICAL STRESS.

Additional Manufacturer Narrative · 1

(B)(4). RETURNED PRODUCT SHOWS SOME LCD CHARACTERS MISSING, WHICH MAY CAUSE INCORRECT INTERPRETATION OF METER RESULTS. MOST LIKELY UNDERLYING ROOT CAUSE OF MALFUNCTION: METER DROPPED/IMPACTED/STRESSED ENOUGH TO BREAK LCD.

Description of Event or Problem · 1

CONSUMER CALLED. METER LCD DISPLAY SHOWS PARTIAL CHARACTERS. NO ADVERSE EVENT REPORTED.

Description of Event or Problem · 1

CONSUMER CALLED. METER LCD DISPLAY SHOWS PARTIAL CHARACTERS. NO ADVERSE EVENT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
563261 TRUETRACK BLOOD GLUCOSE SYSTEM NBW NIPRO DIAGNOSTICS, INC. TRUETRACK RR4336

Patients

Seq Age Sex Outcome Treatment
1 0 YR