FDA Adverse Event Malfunction Summary report: N

FREESTYLE LIBRE

MDR report key: 12863474 · Received November 23, 2021

Report

Report Number
2954323-2021-93413
Event Type
Malfunction
Date Received
November 23, 2021
Date of Event
November 2, 2021
Report Date
November 8, 2022
Manufacturer
ABBOTT DIABETES CARE INC
Product Code
PZE
PMA / PMN Number
P160030
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

REPEATED ATTEMPTS BY ADC TO RETRIEVE THE PRODUCT WERE UNSUCCESSFUL AND/OR THE CUSTOMER DISCARDED THE PRODUCT. NO PRODUCT HAS BEEN RETURNED. EXTENDED INVESTIGATION HAS BEEN PERFORMED FOR THE REPORTED COMPLAINT AND THERE WAS NO INDICATION THAT THE PRODUCT DID NOT MEET SPECIFICATION. DHR FOR THE LIBRE READER WERE REVIEWED AND THE DHR SHOWED THE LIBRE READER PASSED ALL TESTS PRIOR TO RELEASE. DHRS FOR THE PRECISION STRIPS WAS REVIEWED AND THE DHRS SHOWED THE PRECISION STRIPS PASSED ALL TESTS PRIOR TO RELEASE. RETAIN TESTING WAS PERFORMED FOR PRECISION STRIPS AND ALL UNITS PERFORMED IN SPECIFICATION AND PASSED. IF THE PRODUCT IS RETURNED, A PHYSICAL INVESTIGATION WILL BE PERFORMED, AND A FOLLOW-UP REPORT SUBMITTED. ALL PERTINENT INFORMATION AVAILABLE TO ABBOTT DIABETES CARE HAS BEEN SUBMITTED. THIS IS A CORRECTION TO THE REPORT EMDR-222681. THE DEVICE HISTORY REVIEW FOR PRECISION STRIPS, SECTION H10 (ADDTL MFG NARRATIVE), WAS LEFT OUT OF THE EMDR-222681 REPORT.

Additional Manufacturer Narrative · 0

REPEATED ATTEMPTS BY ADC TO RETRIEVE THE PRODUCT WERE UNSUCCESSFUL AND/OR THE CUSTOMER DISCARDED THE PRODUCT. NO PRODUCT HAS BEEN RETURNED. EXTENDED INVESTIGATION HAS BEEN PERFORMED FOR THE REPORTED COMPLAINT AND THERE WAS NO INDICATION THAT THE PRODUCT DID NOT MEET SPECIFICATION. DHR FOR THE LIBRE READER WERE REVIEWED AND THE DHR SHOWED THE LIBRE READER PASSED ALL TESTS PRIOR TO RELEASE. DHRS FOR THE PRECISION STRIPS WAS REVIEWED AND THE DHRS SHOWED THE PRECISION STRIPS PASSED ALL TESTS PRIOR TO RELEASE. RETAIN TESTING WAS PERFORMED FOR PRECISION STRIPS AND ALL UNITS PERFORMED IN SPECIFICATION AND PASSED. IF THE PRODUCT IS RETURNED, A PHYSICAL INVESTIGATION WILL BE PERFORMED, AND A FOLLOW-UP REPORT SUBMITTED. ALL PERTINENT INFORMATION AVAILABLE TO ABBOTT DIABETES CARE HAS BEEN SUBMITTED.THIS SERVES AS A CORRECTION REPORT. SECTION G-3 ( DATE RECEIVED BY MFG) WAS INCORRECTLY DOCUMENTED IN THE PREVIOUS FOLLOW UP #3 REPORT. THE CORRECT G-3 DATE WAS OCT 10, 2022.

Additional Manufacturer Narrative · 0

REPEATED ATTEMPTS BY ADC TO RETRIEVE THE PRODUCT WERE UNSUCCESSFUL AND/OR THE CUSTOMER DISCARDED THE PRODUCT. NO PRODUCT HAS BEEN RETURNED. EXTENDED INVESTIGATION HAS BEEN PERFORMED FOR THE REPORTED COMPLAINT AND THERE WAS NO INDICATION THAT THE PRODUCT DID NOT MEET SPECIFICATION. DHR FOR THE LIBRE READER WERE REVIEWED AND THE DHR SHOWED THE LIBRE READER PASSED ALL TESTS PRIOR TO RELEASE. DHRS FOR THE FS LIBRE SENSOR AND FS LIBRE SENSOR KIT WERE REVIEWED AND THE DHRS SHOWED THE FS LIBRE SENSOR AND SENSOR KIT PASSED ALL TESTS PRIOR TO RELEASE. RETAIN TESTING WAS PERFORMED FOR PRECISION STRIPS AND ALL UNITS PERFORMED IN SPECIFICATION AND PASSED. IF THE PRODUCT IS RETURNED, A PHYSICAL INVESTIGATION WILL BE PERFORMED, AND A FOLLOW-UP REPORT SUBMITTED. ALL PERTINENT INFORMATION AVAILABLE TO ABBOTT DIABETES CARE HAS BEEN SUBMITTED.THIS SERVES AS A CORRECTION REPORT. SECTION H4 - DEVICE MFG DATE WAS INCORRECTLY DOCUMENTED IN THE INITIAL MDR SUBMISSION. THE SECTIONH4 - DEVICE MFG DATE HAS BEEN CORRECTLY UPDATED.

Additional Manufacturer Narrative · 0

THE REPORTED READER HAS BEEN RETURNED AND INVESTIGATED WITH RETAINED TEST STRIPS. VISUALLY INSPECTED THE READER AND NO ISSUES WERE OBSERVED. CONTROL SOLUTION TESTING HAS BEEN PERFORMED AND ALL RESULTS WERE WITHIN RANGE SPECIFICATION. NO MALFUNCTION OR PRODUCT DEFICIENCY WAS IDENTIFIED. ALL PERTINENT INFORMATION AVAILABLE TO ABBOTT DIABETES CARE HAS BEEN SUBMITTED.

Additional Manufacturer Narrative · 0

NO PRODUCT HAS BEEN RETURNED, EXTENDED INVESTIGATION IS PENDING AT THIS TIME. A FOLLOW- UP REPORT WILL BE SUBMITTED ONCE ADDITIONAL INFORMATION IS OBTAINED. THE DEVICE MANUFACTURER DATE FOR THE REPORTED READER IS UNKNOWN. THE DATE ENTERED IN 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 · 0

CUSTOMER REPORTED RECEIVING ERRATIC READINGS ON THEIR ADC FREESTYLE LIBRE BUILT IN METER. CUSTOMER REPORTED RECEIVING READINGS OF 106 MG/DL, 424 MG/DL, 370 MG/DL AND 87 MG/DL WITHIN 10 MINUTES. THE RESULTS WHEN PLOTTED ON A PARKES ERROR GRID FELL INTO THE "C" ZONE SHOWING THE DIFFERENCE IN VALUES TO BE CLINICALLY SIGNIFICANT. THERE WAS NO REPORT OF DEATH, SERIOUS INJURY, OR MISTREATMENT ASSOCIATED WITH THIS EVENT.

Description of Event or Problem · 0

CUSTOMER REPORTED RECEIVING ERRATIC READINGS ON THEIR ADC FREESTYLE LIBRE BUILT IN METER. CUSTOMER REPORTED RECEIVING READINGS OF 106 MG/DL, 424 MG/DL, 370 MG/DL AND 87 MG/DL WITHIN 10 MINUTES. THE RESULTS WHEN PLOTTED ON A PARKES ERROR GRID FELL INTO THE "C" ZONE SHOWING THE DIFFERENCE IN VALUES TO BE CLINICALLY SIGNIFICANT. THERE WAS NO REPORT OF DEATH, SERIOUS INJURY, OR MISTREATMENT ASSOCIATED WITH THIS EVENT.

Description of Event or Problem · 0

CUSTOMER REPORTED RECEIVING ERRATIC READINGS ON THEIR ADC FREESTYLE LIBRE BUILT IN METER. CUSTOMER REPORTED RECEIVING READINGS OF 106 MG/DL, 424 MG/DL, 370 MG/DL AND 87 MG/DL WITHIN 10 MINUTES. THE RESULTS WHEN PLOTTED ON A PARKES ERROR GRID FELL INTO THE "C" ZONE SHOWING THE DIFFERENCE IN VALUES TO BE CLINICALLY SIGNIFICANT. THERE WAS NO REPORT OF DEATH, SERIOUS INJURY, OR MISTREATMENT ASSOCIATED WITH THIS EVENT.

Description of Event or Problem · 0

CUSTOMER REPORTED RECEIVING ERRATIC READINGS ON THEIR ADC FREESTYLE LIBRE BUILT IN METER. CUSTOMER REPORTED RECEIVING READINGS OF 106 MG/DL, 424 MG/DL, 370 MG/DL AND 87 MG/DL WITHIN 10 MINUTES. THE RESULTS WHEN PLOTTED ON A PARKES ERROR GRID FELL INTO THE "C" ZONE SHOWING THE DIFFERENCE IN VALUES TO BE CLINICALLY SIGNIFICANT. THERE WAS NO REPORT OF DEATH, SERIOUS INJURY, OR MISTREATMENT ASSOCIATED WITH THIS EVENT.

Description of Event or Problem · 0

CUSTOMER REPORTED RECEIVING ERRATIC READINGS ON THEIR ADC FREESTYLE LIBRE BUILT IN METER. CUSTOMER REPORTED RECEIVING READINGS OF 106 MG/DL, 424 MG/DL, 370 MG/DL AND 87 MG/DL WITHIN 10 MINUTES. THE RESULTS WHEN PLOTTED ON A PARKES ERROR GRID FELL INTO THE "C" ZONE SHOWING THE DIFFERENCE IN VALUES TO BE CLINICALLY SIGNIFICANT. THERE WAS NO REPORT OF DEATH, SERIOUS INJURY, OR MISTREATMENT ASSOCIATED WITH THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1764407 FREESTYLE LIBRE FLASH GLUCOSE MONITORING SYSTEM PZE ABBOTT DIABETES CARE INC 71938-01 4500184787

Patients

Seq Age Sex Outcome Treatment
1 Unknown