FDA Adverse Event Malfunction Summary report: N

OT PING METER

MDR report key: 3954263 · Received July 24, 2014

Report

Report Number
2939301-2014-18326
Event Type
Malfunction
Date Received
July 24, 2014
Report Date
July 14, 2014
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
PA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

FOLLOW-UP # 1 ¿ (09/30/2014), THE PATIENT¿S METER HAS BEEN RETURNED ON 7/28/2014 AND EVALUATED BY LIFESCAN PRODUCT ANALYSIS ON 9/30/2014 WITH THE FOLLOWING FINDINGS: ANALYSIS WAS NOT POSSIBLE FOR THE METER INVOLVED WITH THIS COMPLAINT DUE TO THE NOTED SECONDARY ISSUE OF PCB CONTAMINATION AT PROCESSOR IC114. 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) 2014, THE REPORTER CONTACTED LIFESCAN USA, ALLEGING CLOUDY. 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
433463 OT PING METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL 3452731

Patients

Seq Age Sex Outcome Treatment
1