FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PROFILE

MDR report key: 447244 · Received March 7, 2003

Report

Report Number
2939301-2003-01790
Event Type
Malfunction
Date Received
March 7, 2003
Report Date
March 4, 2003
Manufacturer
LIFESCAN, INC.
Product Code
CFR
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

MEDICAL AFFAIRS WAS UNABLE TO GET A HOLD OF PT AND WILL BE SENDING PT A LETTER. PT HAD A REACTION OVERNIGHT AFTER THE READING WAS 119MG/DL AND THE PARAMEDICS WERE CALLED. NO OTHER INFO ABOUT THAT INCIDENT WAS DOCUMENTED. THE PT ALSO REPORTED BLOOD GLUCOSE RESULTS OF 128, 148, 167, 121, 159, AND 119MG/DL WITH A LIFESCAN METER, PERFORMED WITHIN 10 MINUTES OF EACH OTHER. BASED ON STATISTICAL METHODOLOGY, THE CALCULATED DIFFERENCE OF THESE GLUCOSE RESULTS EXCEEDS THE EXPECTED VALUE OF <=20% AND/OR <=20MG/DL, THEREBY INDICATING A POTENTIAL MALFUNCTION OF THE METER IN TERMS OF PRECISION.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 33 YR