FDA Adverse Event Injury Summary report: N

OT ULTRA2 METER

MDR report key: 2922457 · Received January 18, 2013

Report

Report Number
3008382007-2013-01073
Event Type
Injury
Date Received
January 18, 2013
Report Date
January 8, 2013
Manufacturer
LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Product Code
NBW
PMA / PMN Number
K053529
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

ON (B)(6) 2013, THE LAY USER/PATIENT CONTACTED LIFESCAN (LFS) ALLEGING HER ONETOUCH ULTRA2 METER WAS NOT POWERING ON. THE COMPLAINT WAS CLASSIFIED BASED ON THE CUSTOMER CARE ADVOCATE' (CCA) DOCUMENTATION. THE PATIENT CLAIMED THE ALLEGED ISSUE BEGAN APPROXIMATELY 2 WEEKS PRIOR TO CONTACTING LFS FOR ASSISTANCE (EXACT DATE/TIME NOT SPECIFIED). THE PATIENT REPORTEDLY MANAGES HER DIABETES WITH AN UNKNOWN TYPE OF ORAL MEDICATION AND DENIED MAKING ANY CHANGES TO HER USUAL DIABETES MANAGEMENT ROUTINE. SHE APPROXIMATELY 3 DAYS AFTER THE ALLEGED ISSUE OCCURRED WITH THE SUBJECT DEVICE, SHE DEVELOPED SYMPTOMS OF "FREQUENT URINATION." SHE CONTACTED HER DOCTOR ON (B)(6) 2013 AND WAS ADVISED BY HER DOCTOR TO MAKE AN APPOINTMENT FOR DENIED RECEIVING ANY TREATMENT FOR URINALYSIS TESTING. NO OTHER DEVICE WAS USED FOR TESTING AND NO OTHER FORM OF TREATMENT WAS ADMINISTERED. AT THE TIME OF TROUBLESHOOTING, THE CCA NOTED THAT THE SUBJECT DEVICE WAS NOT BRAND NEW. THE PATIENT WAS USING THE CORRECT TEST STRIPS. THE POWER ISSUE STILL REMAINED AFTER TROUBLESHOOTING. REPLACEMENT PRODUCTS WERE SENT TO THE PATIENT AND SUBJECT PRODUCTS ARE PENDING RETURN FOR INVESTIGATION. THIS COMPLAINT IS BEING REPORTED BECAUSE, THE PATIENT CLAIMS SHE WAS UNABLE TO TEST HER BLOOD GLUCOSE DUE TO THE REPORTED ISSUE AND REPORTEDLY DEVELOPED SYMPTOMS SUGGESTIVE OF SEVERE HYPERGLYCEMIA AFTER THE ALLEGED METER ISSUE BEGAN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
28068 OT ULTRA2 METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL

Patients

Seq Age Sex Outcome Treatment
1 62 YR Life Threatening