FDA Adverse Event Malfunction Summary report: N

OT VERIO2 METER

MDR report key: 4870255 · Received June 26, 2015

Report

Report Number
2939301-2015-26435
Event Type
Malfunction
Date Received
June 26, 2015
Report Date
June 3, 2015
Manufacturer
LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Product Code
NBW
PMA / PMN Number
K131363
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

ON (B)(6) 2015, THE REPORTER CONTACTED LIFESCAN (B)(4), ALLEGING INACCURATE HIGH RESULTS ON THE SUBJECT METER COMPARED TO ANOTHER METER. NO RESULTS WERE PROVIDED FOR EITHER METER. THIS COMPLAINT IS BEING REPORTED BECAUSE THE UNKNOWN RESULTS MAY 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
416578 OT VERIO2 METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL 3771668

Patients

Seq Age Sex Outcome Treatment
1 78 YR