FDA Adverse Event Malfunction Summary report: N

OT VERIO IQ METER

MDR report key: 2990845 · Received March 5, 2013

Report

Report Number
3008382007-2013-04276
Event Type
Malfunction
Date Received
March 5, 2013
Report Date
February 16, 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
TN, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

ON (B)(6) 2013, THE LAY USER/ PATIENT CONTACTED LIFESCAN (LFS) ALLEGING AN ISSUE WITH THE DATA PORT ON HER ONETOUCH VERIO IQ METER. ON (B)(6) 2013, THE MEDICAL SURVEILLANCE SPECIALIST (MSS) SPOKE WITH THE PATIENT TO OBTAIN AND VERIFY INFORMATION; HOWEVER, THE PATIENT DID NOT WANT TO ANSWER FOLLOW UP QUESTIONS. THE COMPLAINT WAS CLASSIFIED BASED ON THE CONVERSATION BETWEEN THE PATIENT AND THE CUSTOMER CARE ADVOCATE (CCA). THE MSS REVIEWED THE CALL TO OBTAIN AND VERIFY INFORMATION. THE ALLEGED ISSUE BEGAN ON (B)(6) 2013 AT 8AM. THE PATIENT MANAGES HER DIABETES WITH NOVOLOG INSULIN AND LANTUS INSULIN. IT IS NOT KNOWN IF THE PATIENT MADE CHANGES TO HER USUAL DOSE OF MEDICATIONS; HOWEVER, THE PATIENT REPORTEDLY TOOK LESS FOOD AND/ OR DRINK. IMMEDIATELY AFTER, THE PATIENT CLAIMS SHE FELT "SICK" WHICH SHE ASSOCIATED WITH LOW BLOOD SUGAR. NO OTHER SYMPTOMS WERE SPECIFIED. THE PATIENT ALLEGEDLY OBTAINED NEW SUPPLIES IN ORDER TO CONTINUE TESTING WITH ANOTHER DEVICE. THE PATIENT DENIED RECEIVING MEDICAL TREATMENT. THERE WAS NO INDICATION OF MISUSE. REPLACEMENT PRODUCTS WERE SENT TO THE PATIENT. BASED ON THE INFORMATION PROVIDED, THERE IS NO INDICATION THAT THE REPORTED ISSUE CAUSED OR CONTRIBUTED TO A SERIOUS INJURY. THE PATIENT'S REPORTED SYMPTOM OF "SICK" DOES NOT MEET LIFESCAN'S CRITERIA FOR A SERIOUS INJURY. THE PATIENT ALSO DENIED RECEIVING TREATMENT AS A RESULT OF THE ALLEGED ISSUE. HOWEVER, THIS COMPLAINT IS BEING REPORTED BECAUSE THE ALLEGED PRODUCT ISSUE REMAINED UNRESOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
93671 OT VERIO IQ METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL 3326024

Patients

Seq Age Sex Outcome Treatment
1 51 YR