OT SELECT SIMPLE METER

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer,foreign report with the FDA on 2018-11-13 for OT SELECT SIMPLE METER manufactured by Lifescan Europe, A Division Of Cilag Gmbh Intl.

Event Text Entries

[126922287] On (b)(6) 2018, the reporter contacted lifescan (lfs) (b)(4), alleging that the patient? S onetouch select simple meter was reading inaccurately high compared to their feelings and/or normal results. The complaint was classified based on customer service representative (csr) documentation. The reporter stated that the meter issue began approximately 5 days prior to them contacting lfs, alleging that the patient obtained inaccurately high blood glucose results of? 400, 450, 520 and 480 mg/dl? On the subject meter. Meter to feelings/normal results comparisons do not meet the criteria necessary for lfs to determine an inaccuracy. The reporter stated that the patient manages their diabetes using insulin (self-adjuster) and in response to the alleged issue, they increased their normal insulin dose from 16 units to 35 units for 4 days. The reporter alleged that approximately 4 days after the issue began, the patient developed symptoms of? Drowsy and sleepy?. There is no evidence the patient required or received any treatment in response to the symptoms. During troubleshooting, the csr noted that the subject meter was set to the correct unit of measure and the patient did not have control solution. The csr also noted that the patient? S test strips and control solution, had been stored correctly, were within expiry date. Replacement products were sent to the patient. This complaint is being reported because the patient reportedly developed symptoms of a serious injury adverse, whilst using the product. There is insufficient information to rule out the contribution of the subject meter to the event.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3008382007-2018-03121
MDR Report Key8063266
Report SourceCONSUMER,FOREIGN
Date Received2018-11-13
Date of Report2018-10-31
Date Facility Aware2018-10-31
Date Mfgr Received2018-10-31
Date Added to Maude2018-11-13
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMARIANO CHIUSANO
Manufacturer StreetGUBELSTRASSE 34
Manufacturer CityZUG 6300
Manufacturer CountrySZ
Manufacturer Postal6300
Manufacturer G1LIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Manufacturer StreetGUBELSTRASSE 34
Manufacturer CityZUG 6300
Manufacturer CountrySZ
Manufacturer Postal Code6300
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameOT SELECT SIMPLE METER
Generic NameGLUCOSE MONITORING SYS/KIT
Product CodePYV
Date Received2018-11-13
Lot Number4420762
OperatorLAY USER/PATIENT
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerLIFESCAN EUROPE, A DIVISION OF CILAG GMBH INTL
Manufacturer AddressGUBELSTRASSE 34 ZUG 6300 SZ 6300


Patients

Patient NumberTreatmentOutcomeDate
10 2018-11-13

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