FDA Adverse Event
Malfunction
Summary report: N
OT ULTRALINK METER
MDR report key: 3121404
·
Received May 20, 2013
Report
- Report Number
- 3008382007-2013-12335
- Event Type
- Malfunction
- Date Received
- May 20, 2013
- Report Date
- April 26, 2013
- Manufacturer
- LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
- Product Code
- NBW
- PMA / PMN Number
- K073231
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- UT, US
- Reporter Occupation
- PATIENT
Narratives
Description of Event or Problem · 1
ON (B)(6) 2013, THE REPORTER CONTACTED LIFESCAN USA, ALLEGING INACCURATELY HIGH RESULTS WITH THE SUBJECT METER COMPARED TO AN ICU METER, PERFORMED WITHIN 30 MINUTES OF EACH OTHER. THE REPORTER INDICATED THAT THE METER READING ON THE SUBJECT DEVICE WAS "52 POINTS TO 49 POINTS" HIGHER THAN THE ICU METER. THIS COMPLAINT IS BEING REPORTED BECAUSE THE REPORTED RESULTS DID NOT 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 |
|---|---|---|---|---|---|---|---|
| 221602 | OT ULTRALINK METER | GLUCOSE MONITORING SYS/KIT | NBW | LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL | 3377117 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |