FDA Adverse Event Malfunction Summary report: N

OT VERIO IQ METER

MDR report key: 3974512 · Received August 3, 2014

Report

Report Number
2939301-2014-19434
Event Type
Malfunction
Date Received
August 3, 2014
Report Date
July 28, 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
MO, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

ON (B)(6) 2014, THE REPORTER CONTACTED LIFESCAN USA, ALLEGING INACCURATELY HIGH CONTROL SOLUTION RESULTS. THE REPORTER OBTAINED A CONTROL SOLUTION READING OF "148MG/DL" ON THE SUBJECT METER (ONETOUCH VERIO IQ). THIS FALLS OUT WITH THE CONTROL SOLUTION RANGE OF "102-138MG/DL" FOR THIS STRIP LOT. THIS COMPLAINT IS BEING REPORTED BECAUSE THE REPORTED RESULTS DID NOT MEET LIFESCAN¿S 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.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
452419 OT VERIO IQ METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL 3588941

Patients

Seq Age Sex Outcome Treatment
1