FDA Adverse Event Malfunction Summary report: N

OT PING METER

MDR report key: 3013971 · Received March 21, 2013

Report

Report Number
3008382007-2013-05689
Event Type
Malfunction
Date Received
March 21, 2013
Report Date
February 19, 2013
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
UT, US
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

THE LFS PRODUCT HAS BEEN REQUESTED FOR RETURN TO LIFESCAN FOR EVALUATION. IF THE SUBJECT PRODUCT IS RETURNED, AN EVALUATION SHALL BE COMPLETED AND A SUPPLEMENTAL REPORT WILL BE FILED. NO CONCLUSIONS CAN BE MADE AT THIS TIME.

Description of Event or Problem · 1

ON (B)(6) 2013 THE REPORTER CONTACTED LIFESCAN (LFS) IN THE USA ALLEGING THE METER WAS NOT POWERING ON. THERE WAS NO INDICATION THAT THE LFS PRODUCT CAUSED OR CONTRIBUTED TO A ADVERSE EVENT. THIS COMPLAINT IS BEING REPORTED BECAUSE THE ALLEGED ISSUE WAS NOT RESOLVED WITH TROUBLESHOOTING DONE BY THE CUSTOMER CARE ADVOCATE (CCA).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
118117 OT PING METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL

Patients

Seq Age Sex Outcome Treatment
1