FDA Adverse Event
Malfunction
Summary report: N
CONTOUR
MDR report key: 4190282
·
Received October 21, 2014
Report
- Report Number
- 1826988-2014-00369
- Event Type
- Malfunction
- Date Received
- October 21, 2014
- Date of Event
- September 29, 2014
- Report Date
- September 29, 2014
- Manufacturer
- BAYER HEALTHCARE LLC
- Product Code
- NBW
- PMA / PMN Number
- K062058
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TN, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
THE CUSTOMER RECEIVED A BLOOD GLUCOSE READING OF HI ON THE CONTOUR METER, RE-TESTED USING A DIFFERENT BOTTLE OF STRIPS ON THE SAME METER AND THE READING WAS 94MG/DL. THE DIFFERENCE BETWEEN THE READINGS FALLS IN THE "D" 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 WAS SENT TO THE CUSTOMER.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 668718 | CONTOUR | BLOOD GLUCOSE TEST STRIPS | NBW | BAYER HEALTHCARE LLC | 7080G | 4BJ3D03 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |