FDA Adverse Event Injury Summary report: N

FREESTYLE LIBRE 3

MDR report key: 13594516 · Received February 24, 2022

Report

Report Number
2954323-2022-06436
Event Type
Injury
Date Received
February 24, 2022
Date of Event
February 16, 2022
Report Date
April 11, 2022
Manufacturer
ABBOTT DIABETES CARE LTD
Product Code
NBW
PMA / PMN Number
VERIFY
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THE PRODUCT HAS BEEN REQUESTED BACK FOR AN INVESTIGATION. A FOLLOW-UP REPORT WILL BE SUBMITTED ONCE ADDITIONAL INFORMATION IS OBTAINED. THE DEVICE MFG DATE IS UNKNOWN. THE DATE ENTERED IS THE DATE ABBOTT DIABETES CARE BECAME AWARE OF THE EVENT. THIS REPORT IS BEING FILED ON AN INTERNATIONAL PRODUCT, MODEL NUMBER 72114-01 WHICH HAS A SIMILAR PRODUCT DISTRIBUTED IN THE U.S., MODEL NUMBER 71992-01. ALL PERTINENT INFORMATION AVAILABLE TO ABBOTT DIABETES CARE HAS BEEN SUBMITTED.

Additional Manufacturer Narrative · 0

THE PRODUCT HAS BEEN REQUESTED BACK FOR AN INVESTIGATION. A FOLLOW-UP REPORT WILL BE SUBMITTED ONCE ADDITIONAL INFORMATION IS OBTAINED. THE DEVICE MFG DATE IS UNKNOWN. THE DATE ENTERED IS THE DATE ABBOTT DIABETES CARE BECAME AWARE OF THE EVENT. THIS REPORT IS BEING FILED ON AN INTERNATIONAL PRODUCT, MODEL NUMBER 72114-01 WHICH HAS A SIMILAR PRODUCT DISTRIBUTED IN THE U.S., MODEL NUMBER 71992-01. ALL PERTINENT INFORMATION AVAILABLE TO ABBOTT DIABETES CARE HAS BEEN SUBMITTED.

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. AN EXTENDED INVESTIGATION HAS BEEN PERFORMED ON THE REPORTED COMPLAINT AND IT HAS BEEN DETERMINED THAT THERE WAS NO INDICATION THAT THE PRODUCT DID NOT MEET THE SPECIFICATIONS. DHRS FOR THE LIBRE SENSOR AND SENSOR KIT INDICATED WERE REVIEWED AND NO NONCONFORMITIES WERE FOUND THAT WOULD HAVE AN IMPACT ON PRODUCT PERFORMANCE. THE DHRS SHOWED THE LIBRE SENSOR AND SENSOR KITS PASSED ALL TESTS PRIOR TO RELEASE. IF THE PRODUCT IS RETURNED, THE CASE WILL BE RE-OPENED, AND A PHYSICAL INVESTIGATION WILL BE PERFORMED. ALL PERTINENT INFORMATION AVAILABLE TO ABBOTT DIABETES CARE HAS BEEN SUBMITTED.

Additional Manufacturer Narrative · 0

THIS SERVES AS A CORRECTION REPORT. SECTION D1 WAS INCORRECTLY DOCUMENTED IN THE PREVIOUS INITIAL MDR REPORT. THIS SECTION HAVE BEEN UPDATED.

Description of Event or Problem · 0

A SIGNAL LOSS ISSUE WAS REPORTED WITH THE FREESTYLE LIBRE 3 SENSOR. A CUSTOMER REPORTED A SENSOR SIGNAL LOSS AND AS RESULT, EXPERIENCED A LOSS OF CONSCIOUSNESS AND WAS UNABLE TO SELF-TREAT. THE CUSTOMER WAS PROVIDED 2 COOKIES BY A THIRD PARTY AS TREATMENT AND NO FURTHER INFORMATION WAS REPORTED. THERE WAS NO REPORT OF DEATH OR PERMANENT INJURY ASSOCIATED WITH THIS EVENT.

Description of Event or Problem · 0

A SIGNAL LOSS ISSUE WAS REPORTED WITH THE FREESTYLE LIBRE 3 SENSOR. A CUSTOMER REPORTED A SENSOR SIGNAL LOSS AND AS RESULT, EXPERIENCED A LOSS OF CONSCIOUSNESS AND WAS UNABLE TO SELF-TREAT. THE CUSTOMER WAS PROVIDED 2 COOKIES BY A THIRD PARTY AS TREATMENT AND NO FURTHER INFORMATION WAS REPORTED. THERE WAS NO REPORT OF DEATH OR PERMANENT INJURY ASSOCIATED WITH THIS EVENT.

Description of Event or Problem · 0

A SIGNAL LOSS ISSUE WAS REPORTED WITH THE FREESTYLE LIBRE 3 SENSOR. A CUSTOMER REPORTED A SENSOR SIGNAL LOSS AND AS RESULT, EXPERIENCED A LOSS OF CONSCIOUSNESS AND WAS UNABLE TO SELF-TREAT. THE CUSTOMER WAS PROVIDED 2 COOKIES BY A THIRD PARTY AS TREATMENT AND NO FURTHER INFORMATION WAS REPORTED. THERE WAS NO REPORT OF DEATH OR PERMANENT INJURY ASSOCIATED WITH THIS EVENT.

Description of Event or Problem · 0

A SIGNAL LOSS ISSUE WAS REPORTED WITH THE FREESTYLE LIBRE 3 SENSOR. A CUSTOMER REPORTED A SENSOR SIGNAL LOSS AND AS RESULT, EXPERIENCED A LOSS OF CONSCIOUSNESS AND WAS UNABLE TO SELF-TREAT. THE CUSTOMER WAS PROVIDED 2 COOKIES BY A THIRD PARTY AS TREATMENT AND NO FURTHER INFORMATION WAS REPORTED. THERE WAS NO REPORT OF DEATH OR PERMANENT INJURY ASSOCIATED WITH THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1864142 FREESTYLE LIBRE 3 FLASH GLUCOSE MONITORING SYSTEM NBW ABBOTT DIABETES CARE LTD 72114-01

Patients

Seq Age Sex Outcome Treatment
1 Unknown Required Intervention