FDA Adverse Event Malfunction Summary report: N

OT VERIO IQ METER

MDR report key: 3183426 · Received June 22, 2013

Report

Report Number
3008382007-2013-18001
Event Type
Malfunction
Date Received
June 22, 2013
Report Date
June 11, 2013
Manufacturer
LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Product Code
NBW
PMA / PMN Number
K110637
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

ON (B)(6) 2013, THE REPORTER CONTACTED LIFESCAN (B)(4), ALLEGING INACCURATE RESULTS. THE REPORTER ALLEGED INACCURATE HIGH RESULTS. THE REPORTER CLAIMED OBTAINING BLOOD GLUCOSE RESULTS OF ¿ALWAYS HIGHER THAN OT ULTRA METER¿ WITH A VERIO IQ METER AND ¿ALWAYS LOWER THAN VERIO IQ METER¿ ON ANOTHER METER, PERFORMED WITHIN 30 MINUTES OF EACH OTHER. THIS COMPLAINT IS BEING REPORTED BECAUSE THE REPORTED ISSUE WAS NOT RESOLVED WITH TROUBLESHOOTING. THERE IS NO INDICATION THAT THE PRODUCT CAUSED OR CONTRIBUTED TO AN ADVERSE EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
284438 OT VERIO IQ METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL 3242231

Patients

Seq Age Sex Outcome Treatment
1 63 YR