FDA Adverse Event Injury Summary report: N

ONE TOUCH LANCING DEVICE

MDR report key: 3963187 · Received July 29, 2014

Report

Report Number
2939301-2014-18993
Event Type
Injury
Date Received
July 29, 2014
Report Date
July 21, 2014
Manufacturer
LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Product Code
NBW
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NV, US
Reporter Occupation
PATIENT

Narratives

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 LAY USER/PATIENT CONTACTED LIFESCAN (LFS) ALLEGING THAT THE LANCET FROM HER ONE TOUCH LANCING DEVICE (MINI LANCER) DOES NOT FULLY PENETRATE. THE COMPLAINT WAS CLASSIFIED BASED ON THE CUSTOMER CARE ADVOCATE (CCA) DOCUMENTATION. THE PATIENT DOES NOT RECALL WHEN THE ALLEGED ISSUE BEGAN. THE PATIENT MANAGES HER DIABETES WITH INSULIN (UNKNOWN TYPE AND DOSAGE) AND STATED SHE TOOK A DECREASED DOSE OF INSULIN (UNKNOWN TYPE AND DOSAGE) IN RESPONSE TO THE ALLEGED ISSUE. THE PATIENT STATED, AT AN UNSPECIFIED TIME AFTER THE ALLEGED ISSUE OCCURRED, SHE DEVELOPED SYMPTOMS OF ¿SWEATY AND SHAKY¿. THERE WAS NO MENTION OF RECEIVING MEDICAL TREATMENT FOR A HIGH OR LOW BLOOD GLUCOSE EXCURSION. AT THE TIME OF TROUBLESHOOTING, THE CCA DOCUMENTED THAT THIS WAS NOT THE FIRST TIME THE PATIENT USED THE LANCING DEVICE, AND THERE WAS NO MISUSE OF THE PRODUCT. REPLACEMENT PRODUCTS WERE SENT TO THE PATIENT. THIS COMPLAINT IS BEING REPORTED BECAUSE THE PATIENT REPORTEDLY DEVELOPED SIGNS/SYMPTOMS SUGGESTIVE OF A SERIOUS INJURY AFTER THE ALLEGED LANCING DEVICE ISSUE BEGAN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
441445 ONE TOUCH LANCING DEVICE GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL

Patients

Seq Age Sex Outcome Treatment
1 Life Threatening