FDA Adverse Event Injury Summary report: N

FREESTYLE LIBRE 14 DAY

MDR report key: 9076278 · Received September 17, 2019

Report

Report Number
2954323-2019-07174
Event Type
Injury
Date Received
September 17, 2019
Date of Event
June 19, 2019
Report Date
October 24, 2019
Manufacturer
ABBOTT DIABETES CARE INC
Product Code
PZE
PMA / PMN Number
P160030
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
ZA
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THE PRODUCT HAS BEEN REQUESTED BACK FOR AN INVESTIGATION. A FOLLOW-UP REPORT WILL BE SUBMITTED ONCE ADDITIONAL INFORMATION IS OBTAINED. THE DEVICE MFG DATE IS UNKNOWN. THE DATE ENTERED IS THE DATE ABBOTT DIABETES CARE BECAME AWARE OF THE EVENT. ALL PERTINENT INFORMATION AVAILABLE TO ABBOTT DIABETES CARE HAS BEEN SUBMITTED. THIS IS A CORRECTION DOCUMENT FOR DATE RECEIVED BY MFG, THIS SECTION HAS BEEN UPDATED WITH THE CORRECT DATE AS THE INITIAL 30 DAY REPORTED DATE WAS DOCUMENTED INCORRECTLY.

Additional Manufacturer Narrative · 0

SENSOR (B)(4) HAS BEEN RETURNED AND INVESTIGATED. VISUAL INSPECTION HAS BEEN PERFORMED AND NO ISSUES WERE OBSERVED. EXTRACTED DATA FROM RETURNED SENSOR USING APPROVED SOFTWARE. SENSOR FOUND TO BE IN STATE 5 (INDICATING NORMAL TERMINATION). THE SENSOR PLUG WAS RETURNED. THE SENSOR PLUG WAS PROPERLY SEATED IN THE MOUNT. REMOVED THE SENSOR PLUG AND INSPECTED THE PLUG ASSEMBLY, NO ISSUES WERE OBSERVED. SENSOR WAS REPROGRAMMED AND CURRENT WAS APPLIED TO PERFORM LINEARITY TESTING WHILE IN THE TEST FIXTURE. ALL RESULTS WERE WITHIN SPECIFICATION. NO MALFUNCTION OR PRODUCT DEFICIENCY WAS IDENTIFIED. THE DEVICE MFG. DATE IS UNKNOWN. THE DATE ENTERED IS THE DATE ABBOTT DIABETES CARE BECAME AWARE OF THE EVENT. ALL PERTINENT INFORMATION AVAILABLE TO ABBOTT DIABETES CARE HAS BEEN SUBMITTED THIS IS A CORRECTION DOCUMENT. THE INVESTIGATIONAL RESULTS OMITTED FROM THE CORRECTIONAL REPORT.

Description of Event or Problem · 0

A CUSTOMER REPORTED A HIGH READINGS ISSUE WITH THE ADC FREESTYLE LIBRE SENSOR USING FREESTYLE LIBRELINK ON THEIR (B)(6) TO SCAN. ON (B)(6) 2019, THE CUSTOMER SELF-TREATED WITH INSULIN(DOSE UNKNOWN) BASED ON THE UNSPECIFIED HIGH SENSOR SCAN RESULT WITHOUT CONFIRMING BY BLOOD TEST, AND SUBSEQUENTLY BECAME "SWEATY AND ICE COLD". THE CUSTOMER'S HUSBAND CALLED PARAMEDICS WHO TREATED THE CUSTOMER WITH GLUCOSE AND FOOD. THERE WAS NO REPORT OF DEATH OR PERMANENT INJURY ASSOCIATED WITH THIS EVENT.

Description of Event or Problem · 0

A CUSTOMER REPORTED A HIGH READINGS ISSUE WITH THE ADC FREESTYLE LIBRE SENSOR USING FREESTYLE LIBRELINK ON THEIR IPHONE-X PLUS-1241-2211055 TO SCAN. ON (B)(6) 2019 THE CUSTOMER SELF-TREATED WITH INSULIN(DOSE UNKNOWN) BASED ON THE UNSPECIFIED HIGH SENSOR SCAN RESULT WITHOUT CONFIRMING BY BLOOD TEST, AND SUBSEQUENTLY BECAME "SWEATY AND ICE COLD". THE CUSTOMER'S HUSBAND CALLED PARAMEDICS WHO TREATED THE CUSTOMER WITH GLUCOSE AND FOOD. THERE WAS NO REPORT OF DEATH OR PERMANENT INJURY ASSOCIATED WITH THIS EVENT.

Additional Manufacturer Narrative · 1

THE PRODUCT HAS BEEN REQUESTED BACK FOR AN INVESTIGATION. A FOLLOW-UP REPORT WILL BE SUBMITTED ONCE ADDITIONAL INFORMATION IS OBTAINED. THE DEVICE MFG DATE IS UNKNOWN. THE DATE ENTERED IS THE DATE ABBOTT DIABETES CARE BECAME AWARE OF THE EVENT. ALL PERTINENT INFORMATION AVAILABLE TO ABBOTT DIABETES CARE HAS BEEN SUBMITTED.

Description of Event or Problem · 1

A CUSTOMER REPORTED A HIGH READINGS ISSUE WITH THE ADC FREESTYLE LIBRE SENSOR USING FREESTYLE LIBRELINK ON THEIR (B)(6) TO SCAN. ON (B)(6) 2019, THE CUSTOMER SELF-TREATED WITH INSULIN(DOSE UNKNOWN) BASED ON THE UNSPECIFIED HIGH SENSOR SCAN RESULT WITHOUT CONFIRMING BY BLOOD TEST, AND SUBSEQUENTLY BECAME "SWEATY AND ICE COLD". THE CUSTOMER'S HUSBAND CALLED PARAMEDICS WHO TREATED THE CUSTOMER WITH GLUCOSE AND FOOD. THERE WAS NO REPORT OF DEATH OR PERMANENT INJURY ASSOCIATED WITH THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
868519 FREESTYLE LIBRE 14 DAY FLASH GLUCOSE MONITORING SYSTEM PZE ABBOTT DIABETES CARE INC 71940-01

Patients

Seq Age Sex Outcome Treatment
1 53 YR Required Intervention