MAUDE Adverse Event Report: ABBOTT DIABETES CARE INC FREESTYLE LIBRE 2; FLASH GLUCOSE MONITORING SYSTEM

Model Number 71992-01

Device Problem Failure to Fire (2610)

Patient Problems Loss of consciousness (2418); Convulsion/Seizure (4406)

Event Date 08/07/2022

Event Type  Injury  

Event Description

A customer reported via webform that the adc device "applicator jammed and when it was freed, it misfired and we were never able to install the sensor".The customer further reported experiencing a seizure and a loss of consciousness however, they did not receive third parry medical treatment.No further information was provided.There was no report of death or permanent injury associated with this event.

Manufacturer Narrative

At this time product has not yet been returned.An extended investigation has been performed for the reported complaint.There was no indication that the product did not meet specification.The dhrs (device history review) for the libre sensor kit was reviewed and the dhrs showed the libre sensor kit passed all tests prior to release.If the product is returned, a physical investigation will be performed and a follow-up report submitted.The date the incident occurred 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.

Manufacturer Narrative

Applicator (b)(6) has been returned and investigated.Visually inspection has been performed on the applicator and no issues were observed.It is observed that the applicator was fired correctly.Sensor pack (b)(6) has been returned and investigated.Visually inspection has been performed on the sensor pack.It is observed that the lid was completely peeled off.Sensor (b)(6) has been returned and investigated.Visual inspection has been performed and no issues were observed.Visual inspection was performed on the sensor and no issues were observed.The sensor plug was properly seated.The issue is not confirmed.All pertinent information available to abbott diabetes care has been submitted.

Event Description

A customer reported via webform that the adc device "applicator jammed and when it was freed, it misfired and we were never able to install the sensor".The customer further reported experiencing a seizure and a loss of consciousness however, they did not receive third parry medical treatment.No further information was provided.There was no report of death or permanent injury associated with this event.

• Brand Name: FREESTYLE LIBRE 2
• Type of Device: FLASH GLUCOSE MONITORING SYSTEM
• Manufacturer (Section D): ABBOTT DIABETES CARE INC; 1360 south loop road; alameda CA 94502 7001
• Manufacturer Contact: audra fuentes ; 1360 south loop road; alameda, CA 94502-7001 ; 5107495297
• MDR Report Key: 15304531
• MDR Text Key: 298722460
• Report Number: 2954323-2022-31239
• Device Sequence Number: 1
• Product Code: QLG
• UDI-Device Identifier: 00357599800000
• UDI-Public: 00357599800000
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K193371
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Consumer
• Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial,Followup
• Report Date: 02/02/2023

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Lay User/Patient
• Device Expiration Date: 12/31/2022
• Device Model Number: 71992-01
• Device Catalogue Number: 71992
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Initial Date Manufacturer Received: 08/07/2022
• Initial Date FDA Received: 08/26/2022
• Supplement Dates Manufacturer Received: 02/01/2023
• Supplement Dates FDA Received: 02/02/2023
• Was Device Evaluated by Manufacturer?: Yes
• Date Device Manufactured: 05/09/2022
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Patient Sequence Number: 1
• Patient Outcome(s): Other
• Patient Sex: Female