FDA Adverse Event Other Summary report: N

ASCENSIA ELITE BASIC

MDR report key: 638796 · Received September 27, 2005

Report

Report Number
1826988-2005-00022
Event Type
Other
Date Received
September 27, 2005
Date of Event
September 12, 2005
Report Date
September 24, 2005
Manufacturer
BAYER HEALTHCARE, LLC
Product Code
NBW
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

CUSTOMER CALLED STATING THAT THEIR METER IS REPORTING ERRATIC RESULTS. THEIR METER REPORTED A RESULT OF 439 MG/DL COMPARED TO THE HOSP RESULTS OF 114 MG/DL. AN EVALUATION OF THE SYSTEM WAS CONDUCTED OVER THE PHONE, WHICH DETERMINED THAT THE METER WAS WORKING WITHIN SPECIFICATIONS. SENDING OUT CONTROL SOLUTION FOR FURTHER TESTING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ASCENSIA ELITE BASIC BLOOD GLUCOSE METER NBW BAYER HEALTHCARE, LLC 3885G NA

Patients

Seq Age Sex Outcome Treatment
1 45 YR Other