FDA Adverse Event Malfunction Summary report: N

OT VERIO METER

MDR report key: 2771224 · Received October 3, 2012

Report

Report Number
3008382007-2012-04755
Event Type
Malfunction
Date Received
October 3, 2012
Report Date
September 26, 2012
Manufacturer
LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Product Code
NBW
PMA / PMN Number
K093745
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.

Description of Event or Problem · 1

ON (B)(6) 2012, THE LAY USER/ PATIENT CONTACTED LIFESCAN (LFS) (B)(4) ALLEGING THE ONETOUCH VERIO METER READ INACCURATELY COMPARED TO ANOTHER DEVICE. THE PATIENT REPORTED BLOOD GLUCOSE RESULTS OF '12.9, 9.9 AND 9.9 MMOL/L' WITH THE SUBJECT METER AND '10.7, 7.8 AND 7.2 MMOL/L' ON ANOTHER METER, RESPECTIVELY, PERFORMED WITHIN 30 MINUTES OF EACH OTHER. THE PATIENT DID NOT EXPERIENCE ANY SYMPTOMS OR SEEK ANY MEDICAL ATTENTION BECAUSE OF THE REPORTED ISSUE. AS THE RESULTS FELL OUTSIDE EXPECTED VALUES FOR METER TO METER ACCURACY TESTING, THIS COMPLAINT IS BEING REPORTED.

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 3314687

Patients

Seq Age Sex Outcome Treatment
1 57 YR