FDA Adverse Event Malfunction Summary report: N

OT VERIO2 METER

MDR report key: 6860887 · Received September 13, 2017

Report

Report Number
3008382007-2017-22485
Event Type
Malfunction
Date Received
September 13, 2017
Report Date
August 24, 2017
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) 2017, THE REPORTER CONTACTED LIFESCAN (B)(4), ALLEGING INACCURATE ERRATIC RESULTS ON THE SUBJECT METER OF "160, 147 AND 153 MG/DL" AND "155 AND 118 MG/DL" , PERFORMED WITHIN 20 MINUTES OF EACH OTHER. THIS COMPLAINT IS BEING REPORTED BECAUSE THE REPORTED RESULTS DID NOT MEET LIFESCAN¿S PRECISION 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
641592 OT VERIO2 METER GLUCOSE MONITORING SYS/KIT NBW LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL 4172725

Patients

Seq Age Sex Outcome Treatment
1 69 YR