FDA Adverse Event Malfunction Summary report: N

OT VERIO IQ METER

MDR report key: 6506585 · Received April 20, 2017

Report

Report Number
3008382007-2017-18416
Event Type
Malfunction
Date Received
April 20, 2017
Report Date
April 4, 2017
Manufacturer
LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Product Code
NBW
UDI-DI
00353885008402
PMA / PMN Number
K110637
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

ON (B)(6) 2017, THE REPORTER CONTACTED LIFESCAN USA, ALLEGING INACCURATELY HIGH CONTROL SOLUTION RESULTS. THE REPORTER OBTAINED CONTROL SOLUTION READINGS OF "150, 152 AND 170MG/DL" ON THE SUBJECT METER. 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
291418 OT VERIO IQ METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL 00353885008402

Patients

Seq Age Sex Outcome Treatment
1