FDA Adverse Event Malfunction Summary report: N

OT VERIO IQ METER

MDR report key: 3111371 · Received May 14, 2013

Report

Report Number
3008382007-2013-05411
Event Type
Malfunction
Date Received
May 14, 2013
Report Date
February 20, 2013
Manufacturer
LIFESCAN EUROPE GMBH
Product Code
NBW
PMA / PMN Number
K110637
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
003

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
214002 OT VERIO IQ METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE GMBH

Patients

Seq Age Sex Outcome Treatment
1 11 YR Unknown