FDA Adverse Event Malfunction Summary report: N

OT VERIO PRO METER

MDR report key: 2171498 · Received July 21, 2011

Report

Report Number
3008382007-2011-00052
Event Type
Malfunction
Date Received
July 21, 2011
Report Date
June 21, 2011
Manufacturer
LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Product Code
NBW
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PO
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

LIFESCAN (LFS) HAS REQUESTED RETURN OF THE SUBJECT PRODUCT(S) FOR EVALUATION. IF THE PRODUCT(S) ARE RETURNED, LFS WILL EVALUATE IT/THEM AND INFORM FDA OF PRODUCT(S) THAT DO NOT PASS INSPECTION IN A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

THE LAY USER/PATIENT IN (B)(6) CONTACTED LIFESCAN TO REPORT THE ONE TOUCH VERIOPRO METER HAD SEGMENTS MISSING FROM THE CHARACTERS ON THE DISPLAY. THE ISSUE WAS NOT RESOLVED. THE PATIENT SUFFERED NO INJURY DUE TO THIS ISSUE. THE METER WAS REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 OT VERIO PRO METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL

Patients

Seq Age Sex Outcome Treatment
1 18 YR