FDA Adverse Event
Malfunction
Summary report: N
LIVONGO BLOOD GLUCOSE METER
MDR report key: 10254719
·
Received July 9, 2020
Report
- Report Number
- 3011196194-2020-00028
- Event Type
- Malfunction
- Date Received
- July 9, 2020
- Date of Event
- May 22, 2020
- Report Date
- June 29, 2020
- Manufacturer
- LIVONGO HEALTH INC
- Product Code
- NBW
- PMA / PMN Number
- K133584
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
NEITHER THE BLOOD GLUCOSE METER NOR THE TEST STRIPS HAVE BEEN RETURNED TO THE MANUFACTURER. THE DEVICE HAS YET TO BE RECEIVED BY THE MANUFACTURER, SHOULD THE DEVICE BE RETURNED, A SUPPLEMENTAL REPORT WILL BE FILED WITH THE RESULTS OF THE TESTING.
Description of Event or Problem · 1
THE PATIENT REPORTED A COMPLAINT THAT THEIR METER WAS NOT ACCURATE. THE METER WAS COMPARED TO A LAB SAMPLE, AND THE PATIENT REPORTED THE DIFFERENCE BETWEEN THE LIVONGO METER AND THE CAPILLARY TEST WAS GREATER THAN 20%, ALTHOUGH THE EXACT METHOD OF THE CAPILLARY TEST IS UNKNOWN. THE PATIENT WAS SENT A REPLACEMENT BLOOD GLUCOSE METER AND TEST STRIPS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 715436 | LIVONGO BLOOD GLUCOSE METER | BLOOD GLUCOSE METER | NBW | LIVONGO HEALTH INC | BG300C |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 82 YR |