FDA Adverse Event Malfunction Summary report: N

OT VERIO IQ METER

MDR report key: 3233238 · Received July 18, 2013

Report

Report Number
3008382007-2013-20186
Event Type
Malfunction
Date Received
July 18, 2013
Report Date
July 8, 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
TX, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

ON (B)(6) 2013, THE REPORTER CONTACTED LIFESCAN USA, ALLEGING INACCURATELY HIGH RESULTS. THE REPORTER OBTAINED BLOOD GLUCOSE VALUES OF 327MG/DL ON A LIFESCAN METER AND 206MG/DL ON ANOTHER METER WITHIN 30 MINUTES OF EACH OTHER. THIS COMPLAINT IS BEING REPORTED FOR THE FOLLOWING REASON: BASED ON STATISTICAL METHODOLOGY, THE DIFFERENCE BETWEEN THE TWO RESULTS (59%) EXCEEDS THE MAXIMUM ACCEPTABLE VALUE OF 30% DIFFERENCE BETWEEN READINGS COMPARED TO ANOTHER METER WITHIN 30 MINUTES OF EACH OTHER. THE REPORTED RESULTS DID NOT MEET LIFESCAN'S ACCEPTABLE 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. REPLACEMENT PRODUCTS WERE SENT TO THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
332868 OT VERIO IQ METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL

Patients

Seq Age Sex Outcome Treatment
1