FDA Adverse Event Malfunction Summary report: N

GENULTIMATE!

MDR report key: 9862935 · Received March 20, 2020

Report

Report Number
3007197758-2020-00001
Event Type
Malfunction
Date Received
March 20, 2020
Date of Event
March 16, 2020
Report Date
March 20, 2020
Manufacturer
PHARMA TECH SOLUTIONS, INC.
Product Code
NBW
UDI-DI
00868906000100
PMA / PMN Number
K103542
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
003

Narratives

Description of Event or Problem · 1

A CUSTOMER COMPLAINT PROMPTED AN INVESTIGATION BY OUR COMPANY INTO A POTENTIAL PRODUCT MALFUNCTION. WE HAD THE CUSTOMER'S PRODUCT TESTED BY A 3RD-PARTY (INITIAL REPORTER) WITH WHOLE BLOOD AT A LOW GLUCOSE LEVEL AND A HIGH GLUCOSE LEVEL. THE STRIP READINGS WERE COMPARED TO THE GLUCOSE LEVELS, WHICH WERE MEASURED USING A YSI 2300 STAT PLUS GLUCOSE ANALYZER. BY THIS METHOD, IT WAS DETERMINED THAT THE CUSTOMER'S PRODUCT WAS GIVING FALSELY HIGH RESULTS AT THE LOW GLUCOSE LEVEL, WHILE THE HIGH GLUCOSE LEVEL RESULTS WERE WITHIN ACCEPTABLE LIMITS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
326741 GENULTIMATE! BLOOD GLUCOSE TEST STRIPS NBW PHARMA TECH SOLUTIONS, INC. 100-50 9008A 00868906000100

Patients

Seq Age Sex Outcome Treatment
1