FDA Adverse Event Malfunction Summary report: N

OT PING METER

MDR report key: 2890161 · Received December 28, 2012

Report

Report Number
3008382007-2012-09125
Event Type
Malfunction
Date Received
December 28, 2012
Report Date
December 7, 2012
Manufacturer
LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Product Code
NBW
PMA / PMN Number
K082590
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

ON (B)(6) 2012, THE REPORTER CONTACTED LIFESCAN USA, ALLEGING INACCURATE ERRATIC READINGS WITH THE SUBJECT METER. THE REPORTER STATED THEY OBTAINED BLOOD GLUCOSE READING OF "125, 155 AND 189 MG/DL" WITH THE SUBJECT METER, PERFORMED WITHIN 20 MINUTES OF EACH OTHER. THIS COMPLAINT IS BEING REPORTED BECAUSE, THE REPORTED RESULTS DID NOT MEET LIFESCAN'S ACCURACY/PRECISION CRITERIA AND THE ALLEGED INACCURACY ISSUE WAS NOT RESOLVED WITH TROUBLESHOOTING. THERE WAS NO INDICATION THAT THE PRODUCT CAUSED OR CONTRIBUTED TO AN ADVERSE EVENT.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 34 YR