BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    OT VERIO METER

    MDR report key: 2233846 · Received September 4, 2011

    Report

    Report Number
    3008382007-2011-00336
    Event Type
    Malfunction
    Date Received
    September 4, 2011
    Report Date
    August 9, 2011
    Manufacturer
    LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
    Product Code
    NBW
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NL
    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; 510K#: K093745.

    Description of Event or Problem · 1

    THE LAY USER/PATIENT IN THE (B)(6) CONTACTED LIFESCAN TO REPORT THE ONE TOUCH VERIO METER WAS GIVING THE ERROR 4 ERROR MESSAGE. THE PATIENT'S TESTING TECHNIQUE WAS CORRECT AND THE TEST STRIPS CORRECTLY DREW IN THE BLOOD SAMPLE. THE ISSUE WAS NOT RESOLVED WITH TROUBLESHOOTING. THE PATIENT SUFFERED NO INJURY DUE TO THIS ISSUE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 OT VERIO METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL 3087179

    Patients

    Seq Age Sex Outcome Treatment
    1 47 YR