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