FDA Adverse Event Malfunction Summary report: N

OT VERIO IQ METER

MDR report key: 2970886 · Received February 21, 2013

Report

Report Number
3008382007-2013-03327
Event Type
Malfunction
Date Received
February 21, 2013
Report Date
January 25, 2013
Manufacturer
LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Product Code
NBW
PMA / PMN Number
K110637
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

ON (B)(6) 2013, THE REPORTER CONTACTED LIFESCAN USA, ALLEGING OBTAINING AN UNKNOWN ERROR MESSAGE WITH THE SUBJECT METER. PRIOR TO OBTAINING THE ERROR, THE PATIENT CLAIMED SHE HAD DEVELOPED A HEADACHE AND FELT LIGHTHEADED; HOWEVER, DENIED RECEIVING MEDICAL TREATMENT. THIS COMPLAINT IS BEING REPORTED BECAUSE THE REPORTED ISSUE WAS NOT RESOLVED WITH TROUBLESHOOTING. THERE WAS NO INDICATION THAT THE PRODUCT CAUSED OR CONTRIBUTED TO AN ADVERSE EVENT. THE PATIENT WAS SYMPTOMATIC PRIOR TO WHEN THE ERROR STARTED AND THE PATIENT'S REPORTED SYMPTOMS DO NOT MEET LFS' CRITERIA OF A SERIOUS INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
77182 OT VERIO IQ METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL

Patients

Seq Age Sex Outcome Treatment
1