FDA Adverse Event Malfunction Summary report: N

OT VERIO IQ METER

MDR report key: 3062458 · Received April 16, 2013

Report

Report Number
3008382007-2013-08139
Event Type
Malfunction
Date Received
April 16, 2013
Report Date
March 25, 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
NY, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

ON (B)(6) 2013, A REPORTER FOR THE LAY USER/PATIENT CONTACTED LIFESCAN (LFS) ALLEGING THE PATIENT'S ONETOUCH VERIO IQ METER WAS NOT POWERING ON. THE COMPLAINT WAS CLASSIFIED BASED ON THE CUSTOMER CARE ADVOCATE'S (CCA) DOCUMENTATION. THE REPORTER CLAIMED THE ALLEGED ISSUE BEGAN SOMETIME IN THE MORNING ON THE SAME DAY THEY CONTACTED LFS FOR ASSISTANCE. THE PATIENT REPORTEDLY MANAGES HIS DIABETES WITH FIXED DOSE INSULIN (UNKNOWN TYPE) AND DENIED MAKING ANY CHANGES TO HIS MEDICATION IN RESPONSE TO THE ALLEGED ISSUE. THE PATIENT REPORTEDLY DEVELOPED SYMPTOMS OF "DIZZINESS" SOME TIME THAT SAME EVENING BUT DENIED RECEIVING ANY TREATMENT FOR HIS SYMPTOMS. AT THE TIME OF TROUBLESHOOTING, THE CCA NOTED THAT THE SUBJECT DEVICE WAS BRAND NEW. THE PATIENT WAS USING THE CORRECT TEST STRIPS. THE METER DID NOT POWER ON WITH THE POWER BUTTON, BUT DID WITH THE TEST STRIPS. REPLACEMENT PRODUCTS WERE SENT TO THE PATIENT AND SUBJECT PRODUCTS ARE PENDING RETURN FOR INVESTIGATION. BASED ON THE INFORMATION PROVIDED, THERE IS NO INDICATION THAT THE REPORTED ISSUE CAUSED OR CONTRIBUTED TO A SERIOUS INJURY SINCE THE PATIENT SYMPTOMS DID NOT CORRELATE WITH LFS'S DEFINITION SUGGESTIVE OF SEVERE HYPOGLYCEMIA OR HYPERGLYCEMIA, NOR RECEIVE MEDICAL INTERVENTION FOR EITHER OF THESE CONDITIONS. HOWEVER, THIS COMPLAINT IS BEING REPORTED BECAUSE THE ALLEGED PRODUCT ISSUE REMAINED UNRESOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
163111 OT VERIO IQ METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL 3404972

Patients

Seq Age Sex Outcome Treatment
1 59 YR