FDA Adverse Event Injury Summary report: N

OT DELICA PLUS LANCING DEVICE

MDR report key: 16552520 · Received March 16, 2023

Report

Report Number
2939301-2023-00012
Event Type
Injury
Date Received
March 16, 2023
Date of Event
February 17, 2023
Report Date
March 16, 2023
Manufacturer
ASAHI POLYSLIDER COMPANY LIMITED
Product Code
FMK
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
US
Reporter Occupation
003

Narratives

Description of Event or Problem · 0

ON (B)(6) 2023, THE PATIENT CALLED LIFESCAN (LFS) US ALLEGING THAT THEIR ONETOUCH DELICA PLUS LANCING DEVICE WOULD NOT FIRE. THE COMPLAINT WAS CLASSIFIED BASED ON THE CUSTOMER CARE AGENT (CCA) DOCUMENTATION. THE PATIENT STATED THAT THEY HAD A OT DELICA PLUS LANCING DEVICE THAT WOULD NOT FIRE. THE PATIENT ALSO STATED AT THE TIME OF THE CALL THAT THEY HAD A ¿BAD HEADACHE¿ BUT IT IS NOT CLEAR WHETHER THE DEVICE ISSUE CAUSED OR CONTRIBUTED TO THIS. THE PATIENT NORMALLY TREATS THEIR DIABETES WITH PILLS AND DIET AND/OR EXERCISE (SPECIFIC DETAILS NOT PROVIDED). ATTEMPTS WERE MADE TO CALL THE PATIENT FOR CLARIFICATION ON THE SYMPTOMS AND ACTIONS THAT THE PATIENT TOOK FOLLOWING THE SYMPTOMS HOWEVER THESE WERE UNSUCCESSFUL AS THE PATIENT COULD NOT BE REACHED. DURING TROUBLESHOOTING, THE CCA DETERMINED THAT THE PATIENT WAS USING THE CORRECT LANCETS FOR THE DEVICE, WERE USING THE CORRECT TECHNIQUE AND THAT THIS WAS NOT THE FIRST TIME THE PRODUCT WAS BEING USED. A REPLACEMENT DEVICE WAS SENT TO THE PATIENT. ALTHOUGH THERE ARE FEW DETAILS FOR THIS ALLEGED INCIDENT, THIS COMPLAINT IS BEING REPORTED BECAUSE THE PATIENT ALLEGEDLY DEVELOPED SIGNS/SYMPTOMS THAT COULD BE SUGGESTIVE OF A SERIOUS INJURY ADVERSE EVENT AND THE SUBJECT DEVICE CANNOT BE RULED OUT AS A CONTRIBUTING FACTOR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
496414 OT DELICA PLUS LANCING DEVICE GLUCOSE MONITORING SYS/KIT FMK ASAHI POLYSLIDER COMPANY LIMITED

Patients

Seq Age Sex Outcome Treatment
1 Unknown Life Threatening