FDA Adverse Event Malfunction Summary report: N

OT VERIO IQ METER

MDR report key: 3141407 · Received June 3, 2013

Report

Report Number
3008382007-2013-14154
Event Type
Malfunction
Date Received
June 3, 2013
Report Date
May 9, 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
FL, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

ON (B)(6) 2013, THE LAY USER/ PATIENT CONTACTED LIFESCAN (LFS) ALLEGING HIS ONETOUCH VERIO IQ METER READ INACCURATELY HIGH COMPARED TO HIS FEELINGS/ NORMAL BLOOD GLUCOSE RESULTS. THE COMPLAINT WAS CLASSIFIED BASED ON THE CUSTOMER CARE ADVOCATE (CCA) DOCUMENTATION. THE ALLEGED ISSUE BEGAN ON THE EVENING OF (B)(6) 2013. THE PATIENT REPORTED BLOOD GLUCOSE RESULTS OF ¿502, 474 AND 387 MG/DL¿ WITH THE SUBJECT METER. THE PATIENT MANAGES HIS DIABETES WITH HUMALOG INSULIN AND LANTUS INSULIN. IT IS NOT KNOWN IF THE PATIENT MADE CHANGES TO HIS USUAL MANAGEMENT ROUTINE AT THE TIME OF THE ALLEGED ISSUE. ON THE FOLLOWING DAY, THE PATIENT CLAIMED HE FELT A SYMPTOM OF HEADACHE. NO TREATMENT WAS SPECIFIED AT THAT TIME. ON THE AFTERNOON OF (B)(6) 2013, THE PATIENT VISITED HIS PHYSICIAN¿S OFFICE AND OBTAINED BLOOD GLUCOSE RESULTS OF ¿197, 212 AND 202 MG/DL¿ WITH THE PHYSICIAN¿S METER. THE PATIENT WAS ADVISED TO ¿OBTAIN NEW TEST STRIPS.¿ LATER THAT SAME EVENING, THE PATIENT REPORTEDLY ADMINISTERED SELF A DECREASED DOSE OF HUMALOG INSULIN (9 UNITS) AND LANTUS INSULIN (39 UNITS). AT THE TIME OF TROUBLESHOOTING, THE CCA NOTED THE SUBJECT METER WAS SET TO THE CORRECT UNIT OF MEASUREMENT. QUALITY CONTROL TESTING WAS PERFORMED WHICH TESTED OUTSIDE OF SPECIFICATIONS. REPLACEMENT PRODUCTS WERE SENT TO THE PATIENT. BASED ON THE INFORMATION PROVIDED, THERE IS NO INDICATION THAT THE REPORTED ISSUE CAUSED OR CONTRIBUTED TO A SERIOUS INJURY. THE PATIENT'S REPORTED SYMPTOM OF ¿HEADACHE" DOES NOT MEET LIFESCAN'S CRITERIA FOR A SERIOUS INJURY. THE PATIENT DID NOT RECEIVE MEDICAL TREATMENT FOR AN ACUTE COMPLICATION OF DIABETES. HOWEVER, THE COMPLAINT IS BEING REPORTED DUE TO THE FAILING CONTROL SOLUTION TEST RESULT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
245208 OT VERIO IQ METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL 3445743

Patients

Seq Age Sex Outcome Treatment
1 43 YR