FDA Adverse Event Other Summary report: N

NOVAMAX LINK GLUCOSE MONITOR

MDR report key: 4433141 · Received January 13, 2015

Report

Report Number
3004193489-2015-00001
Event Type
Other
Date Received
January 13, 2015
Date of Event
January 2, 2015
Report Date
January 2, 2015
Manufacturer
NOVA BIOMEDICAL CORP
Product Code
NBW
PMA / PMN Number
K040603
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

TEST STRIP LOT # 1020414147, EXPIRATION DATE: 05/2016. CONTROL SOLUTION LOT # NONE. NOVA MAX TEST STRIP INSERT - QUALITY CONTROL. CHECKING THE SYSTEM CONTROL SOLUTION TEST: THE NOVA MAX CONTROL SOLUTION IS USED AS A QUALITY CONTROL CHECK TO MAKE SURE THAT YOUR BLOOD GLUCOSE MONITOR AND THE NOVA MAX GLUCOSE TEST STRIPS ARE WORKING CORRECTLY. DO A CONTROL SOLUTION TEST: EACH TIME YOU OPEN A NEW VIAL OF TEST STRIPS. NOVA BIOMEDICAL AWAITS THE RETURN OF THE DEVICE FOR EVALUATION. SHOULD ANY SIGNIFICANT FINDINGS BE A RESULT OF THAT INVESTIGATION, A FOLLOW-UP REPORT WILL BE FILED.

Description of Event or Problem · 1

IT WAS REPORTED TO NOVA BIOMEDICAL THAT A CONSUMER EXPERIENCED A HYPOGLYCEMIC EVENT REQUIRING MEDICAL INTERVENTION. PRIOR TO THE EVENT THE CONSUMER WAS EXPERIENCING LOW BLOOD GLUCOSE RESULTS ON HER NOVA MAX LINK METER. THIS IS BEING REPORTED AS AN ADVERSE EVENT UNDER THE FDA MEDWATCH REGULATIONS. THE METER AND TEST STRIPS WILL BE RETURNED FOR EVALUATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
30563 NOVAMAX LINK GLUCOSE MONITOR GLUCOSE MONITOR NBW NOVA BIOMEDICAL CORP NA 1020414147

Patients

Seq Age Sex Outcome Treatment
1 UNK Hospitalization| R