BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    OT VERIO IQ METER

    MDR report key: 3100993 · Received May 9, 2013

    Report

    Report Number
    3008382007-2013-10756
    Event Type
    Malfunction
    Date Received
    May 9, 2013
    Report Date
    July 30, 2012
    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
    FL, US
    Reporter Occupation
    PATIENT

    Narratives

    Additional Manufacturer Narrative · 1

    LIFESCAN (LFS) HAS REQUESTED RETURN OF THE SUBJECT PRODUCT(S) FOR EVALUATION. IF THE PRODUCT(S) ARE RETURNED, LFS WILL EVALUATE IT/THEM AND INFORM FDA OF PRODUCT(S) THAT DO NOT PASS INSPECTION IN A SUPPLEMENTAL REPORT.

    Description of Event or Problem · 1

    ON (B)(60 2012, THE REPORTER CONTACTED LIFESCAN USA, ALLEGING THAT THE SUBJECT METER READ INACCURATELY LOW COMPARED TO ANOTHER DEVICE. THE REPORTED CLAIMED OBTAINING BLOOD GLUCOSE READINGS OF "A 27 POINT DIFFERENCE" WITH THE SUBJECT METER READING LOWER THAN THE OTHER METER. THE TESTS WERE PERFORMED WITHIN AN UNKNOWN TIMEFRAME. THIS COMPLAINT IS BEING REPORTED BECAUSE WE ARE UNABLE TO DETERMINE IF THE REPORTED RESULTS MEET LIFESCAN'S ACCURACY 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
    204215 OT VERIO IQ METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL

    Patients

    Seq Age Sex Outcome Treatment
    1 65 YR