FDA Adverse Event Injury Summary report: N

OT ULTRA EASY METER

MDR report key: 3180796 · Received June 20, 2013

Report

Report Number
3008382007-2013-17918
Event Type
Injury
Date Received
June 20, 2013
Report Date
May 29, 2013
Manufacturer
LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Product Code
NBW
PMA / PMN Number
K061118
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

ON (B)(6) 2013 THE LAY USER/PATIENT CONTACTED LIFESCAN (LFS) IN (B)(4) ALLEGING HER ONETOUCH ULTRA EASY METER WAS DISPLAYING AN ERROR 2 MESSAGE. THE COMPLAINT WAS CLASSIFIED BASED ON THE CUSTOMER SERVICE REPRESENTATIVE (CSR) DOCUMENTATION. THE PATIENT COULD NOT RECALL WHEN THE ALLEGED ISSUE BEGAN. SHE REPORTEDLY MANAGES HER DIABETES WITH METFORMIN PILLS, NOVORAPID INSULIN AFTER MEALS AND LANTUS INSULIN AT BEDTIME AND REPORTED THAT ON THE SAME DAY THE AFTER THE ISSUE OCCURRED SHE ADMINISTERED HER NORMAL DOSE OF 24 UNITS OF NOVORAPID INSULIN. AT AN UNKNOWN TIME AFTER THE ALLEGED ISSUE OCCURRED, SHE REPORTED THAT SHE DEVELOPED SYMPTOMS OF ¿FEELING UNWELL, SHAKY, NERVOUS AND FELT TO BE LOSING CONSCIOUSNESS.¿ AFTER 5-10 MINUTES LATER, SHE SELF-TREATED HER SYMPTOMS BY EATING A BREAD ROLL AND FELT BETTER IMMEDIATELY AFTERWARDS. NO OTHER DEVICE WAS USED FOR TESTING. AT THE TIME OF TROUBLESHOOTING, THE CCA NOTED THAT THE SUBJECT DEVICE WAS NOT BEING USED FOR THE FIRST TIME. THE SUBJECT TEST STRIPS WERE IN GOOD CONDITION AND THE TESTING TECHNIQUE WAS CORRECT. THE ISSUE WAS NOT RESOLVED WITH TROUBLESHOOTING. REPLACEMENT PRODUCTS WERE SENT TO THE PATIENT AND SUBJECT PRODUCTS ARE PENDING RETURN FOR INVESTIGATION. THIS COMPLAINT IS BEING REPORTED BECAUSE THE PATIENT CLAIMS SHE WAS UNABLE TO TEST HER BLOOD GLUCOSE DUE TO THE REPORTED ISSUE AND REPORTEDLY DEVELOPED SYMPTOMS SUGGESTIVE OF HYPOGLYCEMIA AFTER THE ALLEGED METER ISSUE BEGAN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
279585 OT ULTRA EASY METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL 3268857

Patients

Seq Age Sex Outcome Treatment
1 43 YR Life Threatening| R