FDA Adverse Event Injury Summary report: N

OT ULTRAMINI METER

MDR report key: 4171828 · Received October 15, 2014

Report

Report Number
2939301-2014-27476
Event Type
Injury
Date Received
October 15, 2014
Report Date
October 7, 2014
Manufacturer
LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Product Code
NBW
PMA / PMN Number
K061118
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

ON (B)(6) 2014, THE LAY USER/PATIENT CONTACTED LIFESCAN (LFS) ALLEGING HER ONETOUCH ULTRAMINI METER WOULD NOT POWER ON. THE COMPLAINT WAS CLASSIFIED BASED ON THE CUSTOMER CARE ADVOCATE (CCA) DOCUMENTATION. THE PATIENT ALLEGED THE POWER ISSUE WITH THE SUBJECT METER STARTED ON (B)(6) 2014. THE PATIENT INFORMED THE CCA THAT SHE MANAGES HER DIABETES WITH INSULIN (SELF-ADJUSTER) AND DENIED MAKING ANY CHANGES TO HER USUAL DIABETES MANAGEMENT REGIMEN DUE TO THE METER ISSUE. HOWEVER, THE PATIENT REPORTED DEVELOPING SYMPTOMS OF ¿DIZZY, THIRSTY AND NAUSEATED¿ ON AN UNSPECIFIED DATE ¿ABOUT 1.5 WEEKS¿ AFTER THE ALLEGED METER ISSUE BEGAN. THE PATIENT REPORTED, ON (B)(6) 2014, BEING TAKEN TO THE EMERGENCY ROOM (ER) WHERE, SHE ALLEGED, SHE OBTAINED A BLOOD GLUCOSE RESULT ON AN ER/HOSPITAL METER OF ¿437 MG/DL¿ AND WAS TREATED BY A HEALTHCARE PROFESSIONAL (HCP)WITH ¿40 UNITS OF LANTUS¿ INSULIN, INSTEAD OF ¿37 REGULAR.¿ AT THE TIME OF TROUBLESHOOTING, THE CCA NOTED THAT THE METER WAS NOT BEING USED FOR THE FIRST TIME AND THERE WAS NO MISUSE OF THE PRODUCT. AS THE PATIENT HAD DISPOSED OF THE METER, IT IS NOT KNOWN WHETHER THE METER WOULD POWER ON MANUALLY WITH A BUTTON PRESS, OR WHEN A TEST STRIP WAS INSERTED, OR WHETHER THE METER¿S BATTERIES NEEDED TO BE REPLACED. REPLACEMENT PRODUCTS WERE SENT TO THE PATIENT. THIS COMPLAINT IS BEING REPORTED BECAUSE THE PATIENT REPORTEDLY DEVELOPED SIGNS/SYMPTOMS SUGGESTIVE OF HYPERGLYCEMIA AFTER THE ALLEGED POWER ISSUE BEGAN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
653838 OT ULTRAMINI METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL

Patients

Seq Age Sex Outcome Treatment
1 102 YR Life Threatening| R