FDA Adverse Event Malfunction Summary report: N

OT VERIO IQ METER

MDR report key: 3945657 · Received July 21, 2014

Report

Report Number
2939301-2014-17854
Event Type
Malfunction
Date Received
July 21, 2014
Report Date
July 10, 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
CA
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

ON (B)(6) 2014, THE REPORTER CONTACTED LIFESCAN USA ALLEGING THAT THE SUBJECT METER (ONE TOUCH VERIO IQ) READ INACCURATELY LOW COMPARED TO ANOTHER DEVICE. THE REPORTER CLAIMED OBTAINING A BLOOD GLUCOSE READING OF 6.8MMOL/L WITH THE SUBJECT METER AND 10.2MMOL/L ON ANOTHER DEVICE (ONE TOUCH ULTRA 2), PERFORMED WITHIN 30 MINUTES OF EACH OTHER. BASED ON STATISTICAL METHODOLOGY, THE CALCULATED DIFFERENCE OF THESE GLUCOSE RESULTS EXCEEDS LIFESCAN¿S CRITERIA FOR ACCURACY. 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
424857 OT VERIO IQ METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL 3495269

Patients

Seq Age Sex Outcome Treatment
1 57 YR