FDA Adverse Event Malfunction Summary report: N

OT VERIO IQ METER

MDR report key: 3921624 · Received July 9, 2014

Report

Report Number
2939301-2014-16879
Event Type
Malfunction
Date Received
July 9, 2014
Report Date
July 2, 2014
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
MD, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

FOLLOW-UP # 1 ¿ (09/15/2014). THE PATIENT¿S METER HAS BEEN RETURNED ON 8/13/2014 AND EVALUATED BY LIFESCAN PRODUCT ANALYSIS ON 9/3/2014 WITH THE FOLLOWING FINDINGS:THE METER PASSED ALL TESTING WITH NO FAULTS FOUND. THE REPORTED ISSUE COULD NOT BE REPRODUCED. IF LIFESCAN OBTAINS ADDITIONAL INFORMATION REGARDING THIS COMPLAINT, A FOLLOW UP REPORT WILL BE SUBMITTED. AT THIS TIME, LIFESCAN CONSIDERS THIS MATTER CLOSED.

Additional Manufacturer Narrative · 1

LIFESCAN (LFS) HAS REQUESTED RETURN OF THE SUBJECT PRODUCT(S) FOR EVALUATION. IF THE PRODUCT(S) ARE RETURNED, LFS WILL EVALUATE IT/THEM AND INFORM FDA OF PRODUCT(S) THAT DO NOT PASS INSPECTION IN A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

ON (B)(6) 2014, THE REPORTER CONTACTED LIFESCAN USA, ALLEGING INACCURATELY HIGH RESULTS ON THEIR ONE TOUCH VERIO IQ METER COMPARED TO FEELINGS/NORMAL READINGS AS WELL AS COMPARED TO ANOTHER UNKNOWN METER. THE REPORTER CLAIMED OBTAINING BLOOD GLUCOSE READINGS OF "375 AND 326MG/DL" WITH THE SUBJECT METER, WHICH THE REPORTER CLAIMED WERE HIGHER THAN THEY FELT AT THE TIME. ADDITIONALLY, THE REPORTER CLAIMED TO HAVE OBTAINED A BLOOD GLUCOSE READING OF "253MG/DL" ON THE SUBJECT METER AND "112MG/DL" ON ANOTHER UNKNOWN DEVICE, PERFORMED WITHIN 30 MINUTES OF EACH OTHER. BASED ON STATISTICAL METHODOLOGY, THE CALCULATED DIFFERENCE OF THESE GLUCOSE RESULTS EXCEEDS LIFESCAN¿S CRITERIA FOR ACCURACY. THE ALLEGED INACCURACY 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
399865 OT VERIO IQ METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL 3608573

Patients

Seq Age Sex Outcome Treatment
1