FDA Adverse Event Injury Summary report: N

FREESTYLE LIBRE 2

MDR report key: 11823139 · Received May 13, 2021

Report

Report Number
2954323-2021-69205
Event Type
Injury
Date Received
May 13, 2021
Date of Event
March 1, 2021
Report Date
May 13, 2021
Manufacturer
ABBOTT DIABETES CARE INC
Product Code
QLG
PMA / PMN Number
K193371
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 1

ABBOTT DIABETES CARE PRODUCT QUALITY ENGINEERING (PQE) INVESTIGATED THE ALARM-3 (MISSING HIGH OR LOW GLUCOSE ) COMPLAINT. THE SERIAL NUMBER OF THE FREESTYLE LIBRE 2 SENSOR ASSOCIATED WITH THIS COMPLAINT IS UNKNOWN. DURING INVESTIGATION OF THE TRACK AND TREND REVIEW RELATED TO ALARM-3 CASES IN (B)(6) 2020, THIS FAILURE MODE WAS IDENTIFIED AND IS A KNOWN MANUFACTURING ISSUE THAT IMPACTS LIBRE 2 SENSORS MANUFACTURED AT (B)(4). AS THE SERIAL NUMBER OF THE SENSOR ASSOCIATED WITH THIS COMPLAINT IS UNKNOWN, PQE IS UNABLE TO DETERMINE IF THE SENSOR IS IMPACTED BY THIS MANUFACTURING ISSUE. OUTSIDE OF THE KNOWN MANUFACTURING ISSUE, THE AVAILABLE TRIPPED TREND REPORTS FOR LIBRE 2 SENSOR AND ALARM-3 HAVE BEEN REVIEWED. THE REVIEW DID NOT IDENTIFY ANY ADDITIONAL TRENDS THAT WOULD INDICATE A PRODUCT RELATED ISSUE RELATED TO THIS COMPLAINT. IF THE PRODUCT IS RETURNED, A PHYSICAL INVESTIGATION WILL BE PERFORMED AND A FOLLOW-UP REPORT SUBMITTED. THE EXACT DATE THE INCIDENT OCCURRED IS UNKNOWN. THE DATE ENTERED IS PER THE CUSTOMER REPORT OF "IN (B)(6)". THE DEVICE MANUFACTURING DATE IS UNKNOWN. THE DATE ENTERED IS THE DATE ABBOTT DIABETES CARE BECAME AWARE OF THE EVENT. ALL PERTINENT INFORMATION AVAILABLE TO ABBOTT DIABETES CARE HAS BEEN SUBMITTED.

Description of Event or Problem · 1

A CUSTOMER REPORTED VIA EMAIL THAT THE FREESTYLE LIBRE 2 SENSOR FAILED TO ALERT HER TO HYPOGLYCEMIA, AND AS A RESULT CUSTOMER HAD CAR ACCIDENT. NO FURTHER INFORMATION WAS PROVIDED. THERE WAS NO REPORT OF DEATH OR PERMANENT INJURY ASSOCIATED WITH THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
712423 FREESTYLE LIBRE 2 FLASH GLUCOSE MONITORING SYSTEM QLG ABBOTT DIABETES CARE INC 71992-01

Patients

Seq Age Sex Outcome Treatment
1 51 YR