FDA Adverse Event Malfunction Summary report: N

OT PING ENHANCED METER

MDR report key: 4131061 · Received October 1, 2014

Report

Report Number
2939301-2014-25993
Event Type
Malfunction
Date Received
October 1, 2014
Report Date
September 25, 2014
Manufacturer
LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Product Code
NBW
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

FOLLOW-UP # 1 ¿ (02/07/2015). THE PATIENT¿S METER HAS BEEN RETURNED ON 1/9/2015 AND EVALUATED BY LIFESCAN PRODUCT ANALYSIS ON 1/23/2015 WITH THE FOLLOWING FINDINGS:THE METER INVOLVED WITH THIS COMPLAINT FAILED TESTING. THE METER¿S LCD WAS FOUND TO BE DEFECTIVE. IN ADDITION, A SECONDARY ISSUE WAS NOTED WHEN THE METER WAS FOUND TO HAVE A BLANK SERIAL NUMBER LABEL. 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 (B)(4), ALLEGING CONTRAST ISSUE. 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
613104 OT PING ENHANCED METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL

Patients

Seq Age Sex Outcome Treatment
1 8 YR