BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ONE TOUCH ULTRALINK METER

    MDR report key: 1162416 · Received September 9, 2008

    Report

    Report Number
    2939301-2008-02136
    Event Type
    Malfunction
    Date Received
    September 9, 2008
    Report Date
    August 25, 2008
    Manufacturer
    LIFESCAN, INC.
    Product Code
    NBW
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    LAY USER/PATIENT

    Narratives

    Additional Manufacturer Narrative · 1

    LIFESCAN HAS REQUESTED THE RETURN OF THE SUBJECT METER FOR EVALUATION, BUT HAS NOT YET RECEIVED IT. IF THE METER IS RETURNED, LIFESCAN WILL EVALUATE IT AND, IF THE METER DOES NOT PASS INSPECTION, LIFESCAN WILL INFORM FDA OF THE RESULTS IN A SUPPLEMENTAL REPORT.

    Description of Event or Problem · 1

    PATIENT'S MOTHER CALLED AND STATED THAT THE PT'S ULTRALINK METER HAS BACK MARKS ON THEM AND IT LOOKS LIKE THE DISPLAY WAS CRACKED. THE PATIENT DID NOT EXHIBIT ANY SYMPTOMS OR SEEK ANY MEDICAL INTERVENTION DUE TO THE REPORTED ISSUE. THE REPORTER WAS UNABLE/UNWILLING TO VERIFY WHETHER THERE WAS ANY METER TRAUMA. THE METER IS NOT A NEW PRODUCT (OUT OF BOX). THE METER WAS REPLACED. THE COMPLAINT IS BEING REPORTED DUE TO THE DAMAGED DISPLAY ON THE ULTRALINK METER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ONE TOUCH ULTRALINK METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN, INC. NA 2823281

    Patients

    Seq Age Sex Outcome Treatment
    1