FDA Adverse Event Malfunction Summary report: N

OT ULTRALINK METER

MDR report key: 3011841 · Received March 19, 2013

Report

Report Number
3008382007-2013-05612
Event Type
Malfunction
Date Received
March 19, 2013
Report Date
February 22, 2013
Manufacturer
LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Product Code
NBW
PMA / PMN Number
K073231
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4): THE TEST STRIPS INVOLVED WITH THIS COMPLAINT WERE FOUND RESULTS OUTSIDE THE ACCEPTABLE CONTROL RANGE. IF LIFESCAN OBTAINS ADDITIONAL INFORMATION REGARDING THIS COMPLAINT, A FOLLOW UP REPORT WILL BE SUBMITTED. AT THIS TIME, LIFESCAN CONSIDERS THIS MATTER CLOSED.

Additional Manufacturer Narrative · 1

THE PATIENT'S PRODUCTS HAVE BEEN RETURNED TO LIFESCAN FOR EVALUATION; HOWEVER THE EVALUATION PROCESS HAS NOT YET BEEN COMPLETED. NO CONCLUSIONS CAN BE MADE AT THIS TIME.

Description of Event or Problem · 1

ON (B)(6) 2013 THE LAY USER/PATIENT IN USA CONTACTED LIFESCAN TO REPORT THE ONE TOUCH ULTRALINK METER WAS GIVING INACCURATELY LOW READINGS WITH THE CONTROL SOLUTION. THE PATIENT OBTAINED THE CONTROL SOLUTION READINGS OF 119 MG/DL AND 117 MG/DL ON THE REPORTED METER. THERE WAS NO PATIENT INJURY ASSOCIATED WITH THIS ISSUE. AS THE ISSUE WAS NOT RESOLVED AND THE RESULTS FELL OUT OF RANGE FOR THE LOT OF TEST STRIPS IN USE, THIS COMPLAINT IS BEING REPORTED. 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
113478 OT ULTRALINK METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL 3426698

Patients

Seq Age Sex Outcome Treatment
1