FDA Adverse Event Malfunction Summary report: N

OT PING METER

MDR report key: 3220482 · Received July 11, 2013

Report

Report Number
3008382007-2013-19380
Event Type
Malfunction
Date Received
July 11, 2013
Report Date
June 30, 2013
Manufacturer
LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Product Code
NBW
PMA / PMN Number
K082590
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

FOLLOW-UP # 1 (09/10/2013)-PRODUCT EVALUATION:THE SUBJECT METER WAS RETURNED ON 08/22/2013 AND ANALYSIS COMPLETED ON 09/03/2013 BY LIFESCAN PRODUCT ANALYSIS WITH THE FOLLOWING FINDINGS: THE REPORTED DISPLAY ISSUE WAS CONFIRMED IN THE LABORATORY. THE ANALYSIS OF THE SUBJECT METER FOUND THAT THE LCD SCREEN WAS DEFECTIVE. IF LIFESCAN OBTAINS ADDITIONAL INFORMATION REGARDING THIS COMPLAINT, A FOLLOW UP REPORT WILL BE SUBMITTED. AT THIS TIME, LIFESCAN CONSIDERS THIS MATTER CLOSED.

Description of Event or Problem · 1

ON (B)(6) 2013, THE REPORTER CONTACTED LIFESCAN USA, ALLEGING METER REVERTING TO SETUP MODE. THIS COMPLAINT IS BEING REPORTED BECAUSE THE REPORTED 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
320905 OT PING METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL

Patients

Seq Age Sex Outcome Treatment
1