FDA Adverse Event Injury Summary report: N

OT ULTRA METER

MDR report key: 10000408 · Received April 27, 2020

Report

Report Number
2939301-2020-02624
Event Type
Injury
Date Received
April 27, 2020
Date of Event
April 24, 2020
Report Date
April 24, 2020
Manufacturer
LIFESCAN EUROPE GMBH
Product Code
NBW
Report Source
Distributor report
Reporter Location
US
Reporter Occupation
003

Narratives

Description of Event or Problem · 1

ON (B)(6) 2020, THE LAY USER/PATIENT CONTACTED LIFESCAN (LFS) USA, ALLEGING THAT HER ULTRA METER WAS READING INACCURATELY ERRATIC. THE COMPLAINT WAS CLASSIFIED BASED ON INFORMATION OBTAINED FROM THE CUSTOMER SERVICE REPRESENTATIVE (CSR) DOCUMENTATION. THE PATIENT REPORTED THAT THE ALLEGED ISSUE BEGAN ON AN UNSPECIFIED DATE, DURING THE WEEK SHE CONTACTED LFS. THE PATIENT CLAIMED THAT THROUGHOUT THE COURSE OF THE WEEK SHE CONTACTED LFS, SHE OBTAINED BLOOD GLUCOSE RESULTS OF ¿78, 64, 160, 171, 200, 172, 187 AND 231 MG/DL¿ WITH THE SUBJECT DEVICE. THE PATIENT MANAGES HER DIABETES WITH SELF-ADJUSTED INSULIN (30 UNITS OF LANTUS AND HUMALOG) AND SHE DENIED MAKING ANY CHANGES TO HER USUAL DIABETES MANAGEMENT REGIMEN IN RESPONSE TO THE ALLEGED ISSUE. THE PATIENT CLAIMED THAT AT 1 P.M., ON (B)(6) 2020, SHE TESTE HER BLOOD GLUCOSE USING THE SUBJECT DEVICE AND CLAIMED OBTAINING A RESULT OF ¿231 MG/DL¿; HOWEVER, ADVISED THAT SHE BELIEVED THIS TO BE INACCURATE AS SHE WAS FEELING ¿SHAKY¿ WHICH SHE ASSOCIATED WITH A LOW BLOOD GLUCOSE EXCURSION. THE PATIENT DENIED RECEIVING MEDICAL TREATMENT AS A RESULT OF THE ALLEGED INACCURACY ISSUE. REPLACEMENT PRODUCTS WERE SENT TO THE PATIENT. THIS COMPLAINT IS BEING REPORTED BECAUSE THE PATIENT REPORTEDLY DEVELOPED SYMPTOMS SUGGESTIVE OF A SERIOUS INJURY ADVERSE EVENT AFTER THE ALLEGED ISSUE OCCURRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
463541 OT ULTRA METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE GMBH 4589788

Patients

Seq Age Sex Outcome Treatment
1 Life Threatening