FDA Adverse Event Malfunction Summary report: N

OT VERIO IQ METER

MDR report key: 3062392 · Received April 16, 2013

Report

Report Number
3008382007-2013-08088
Event Type
Malfunction
Date Received
April 16, 2013
Report Date
March 22, 2013
Manufacturer
LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Product Code
NBW
PMA / PMN Number
K110637
Removal / Correction Number
2013-IE-017
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

ON (B)(6) 2013, THE REPORTER CONTACTED LIFESCAN (B)(4), ALLEGING INACCURATE RESULTS OF "110 AND 190 MG/DL" WITH THE SUBJECT METER, PERFORMED WITHIN AN UNSPECIFIED TIME OF EACH OTHER. THIS COMPLAINT IS BEING REPORTED BECAUSE THE REPORTED RESULTS DID NOT MEET LIFESCAN¿S ACCURACY/PRECISION CRITERIA AND THE ALLEGED INACCURACY ISSUE WAS NOT RESOLVED WITH TROUBLESHOOTING. 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
162036 OT VERIO IQ METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL

Patients

Seq Age Sex Outcome Treatment
1 7 YR