FDA Adverse Event Malfunction Summary report: N

OT PING ENHANCED METER

MDR report key: 4011753 · Received August 15, 2014

Report

Report Number
2939301-2014-20759
Event Type
Malfunction
Date Received
August 15, 2014
Report Date
July 31, 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
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

FOLLOW-UP # 1 ¿ (02/20/2015). THE PATIENT¿S METER HAS BEEN RETURNED ON 2/2/2015 AND EVALUATED BY LIFESCAN PRODUCT ANALYSIS ON 2/7/2015 WITH THE FOLLOWING FINDINGS:THE METER INVOLVED WITH THIS COMPLAINT FAILED TESTING. THE METER¿S LCD WAS FOUND TO BE FADED. 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

IF ADDITIONAL INVESTIGATION OCCURS REGARDING THIS ISSUE AS A RESULT OF FOLLOW-UP WITH THE CUSTOMER OR PRODUCT RETURN, LFS (LIFESCAN) WILL REPORT THE FINDINGS TO THE FDA IN A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

ON (B)(6) 2014, THE REPORTER CONTACTED LIFESCAN (B)(4), ALLEGING FADING DISPLAY. 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
489225 OT PING ENHANCED METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL

Patients

Seq Age Sex Outcome Treatment
1 52 YR