MAUDE Adverse Event Report: ABBOTT DIABETES CARE INC PRECISION XCEED PRO; BLOOD GLUCOSE MONITORING SYSTEM

Model Number	70900-01
Medical Device Problem Code	Incorrect, Inadequate or Imprecise Result or Readings (1535)
Health Effect - Clinical Code	No Known Impact Or Consequence To Patient (2692)
Date of Event	04/11/2017
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
The product has been requested back for an investigation.A follow-up report will be submitted once additional information is obtained.The date of event is unknown.The date entered is the complaint awareness date.The device manufacturer date for the reported meter serial number is unknown.The date entered is the complaint awareness date.All pertinent information available to abbott diabetes care has been submitted.
Event or Problem Description
Health professional reported receiving erratic readings on their adc blood glucose meter within 10 minutes.Results of 45 mg/dl and 454 mg/dl were plotted on a parkes error grid and the results fell into the "c" zone showing the difference in values to be clinically significant.There was no report of death, serious injury or mistreatment associated with this event.
Additional Manufacturer Narrative
Requested product was not received for investigation.Retained test strip samples from the same lot reported by the customer ((b)(4)) were tested with control solution instead.All results were within the range specification and no errors were observed.The complaint is not confirmed.
Event or Problem Description
Health professional reported receiving erratic readings on their adc blood glucose meter within 10 minutes.Results of 45 mg/dl and 454 mg/dl were plotted on a parkes error grid and the results fell into the "c" zone showing the difference in values to be clinically significant.There was no report of death, serious injury or mistreatment associated with this event.

• Brand Name: PRECISION XCEED PRO
• Common Device Name: BLOOD GLUCOSE MONITORING SYSTEM
• Manufacturer (Section D): ABBOTT DIABETES CARE INC; 1360 south loop road; alameda CA 94502 7001
• MDR Report Key: 6549807
• Report Number: 2954323-2017-03516
• Device Sequence Number: 838617
• Product Code: NBW
• UDI-Device Identifier: 00093815709329
• UDI-Public: (01)00093815709329(17)20180131(10)4C055H
• Combination Product (Y/N): N
• Initial Reporter Country: US
• PMA/510(K) Number: K080960
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: health professional
• Initial Reporter Occupation: Health Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 07/19/2017

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Operator of Device: Health Professional
• Device Expiration Date: 01/31/2018
• Device Model Number: 70900-01
• Device Catalogue Number: 70932
• Device Lot Number: 4C055H
• Was Device Available for Evaluation?: No
• Initial Date Received by Manufacturer: 04/11/2017
• Supplement Date Received by Manufacturer: 07/13/2017
• Initial Report FDA Received Date: 05/05/2017
• Supplement Report FDA Received Date: 07/19/2017
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1