FDA Adverse Event
Malfunction
Summary report: N
TRUERESULT
MDR report key: 4253391
·
Received November 12, 2014
Report
- Report Number
- 1052693-2014-00509
- Event Type
- Malfunction
- Date Received
- November 12, 2014
- Date of Event
- October 13, 2014
- Report Date
- November 12, 2014
- Manufacturer
- NIPRO DIAGNOSTICS, INC.
- Product Code
- NBW
- PMA / PMN Number
- K080641
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- DC, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
PRODUCT NOT YET RETURNED FOR EVALUATION. (B)(4).
Description of Event or Problem · 1
CONSUMER COMPLAINT OF BLOOD RESULT READING OF "HI". CUSTOMER NORMALLY READS 495-550MG/DL WITH THIS METER. LAST 5 BLOOD RESULTS IN MEMORY: HI,HI, 574MG/DL, HI, 492MG/DL. NO ADVERSE EVENT REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 729528 | TRUERESULT | BLOOD GLUCOSE SYSTEM | NBW | NIPRO DIAGNOSTICS, INC. | TRUERESULT | TN2590 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |