MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer report with the FDA on 2019-04-12 for N/A KETONE STRIPS NA manufactured by Trividia Health, Inc..
[145096807]
(manufacturer narrative = t, corrected data = f) internal report: # (b)(4). Product not returned for evaluation. Most likely underlying root cause: mlc-28 there was not enough information to determine the mlurc. Note: manufacturer is unable to reach to customer since no customer address on file nor email/phone information.
Patient Sequence No: 1, Text Type: N, H10
[145096808]
Consumer reported complaint for discoloration of ketone strips pads. Customer emailed regarding ketone strips saying that found that the color that appears on the stick is very faint and dissimilar to the colors on the legend. It's almost impossible for to determine the results. The customer did not report symptoms neither medical attention. The product storage location is undisclosed. The ketone strip lot manufacturer's expiration date is undisclosed and open vial date is undisclosed.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1000113657-2019-00320 |
| MDR Report Key | 8511859 |
| Report Source | CONSUMER |
| Date Received | 2019-04-12 |
| Date of Report | 2019-04-12 |
| Date of Event | 2019-01-30 |
| Date Mfgr Received | 2019-03-19 |
| Date Added to Maude | 2019-04-12 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | KAREN DEVINCENT |
| Manufacturer Street | 2400 NW 55TH COURT |
| Manufacturer City | FORT LAUDERDALE FL 33309 |
| Manufacturer Country | US |
| Manufacturer Postal | 33309 |
| Manufacturer Phone | 954677-920 |
| Single Use | 3 |
| Remedial Action | OT |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | N/A |
| Generic Name | BLOOD GLUCOSE SYSTEM |
| Product Code | JIN |
| Date Received | 2019-04-12 |
| Model Number | KETONE STRIPS |
| Catalog Number | NA |
| Lot Number | N/A |
| Operator | LAY USER/PATIENT |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | TRIVIDIA HEALTH, INC. |
| Manufacturer Address | 2400 NW 55TH COURT FORT LAUDERDALE FL 33309 US 33309 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-04-12 |