Brand Name | LIBRE 3 FREESTYLE SENSOR |
Type of Device | INTEGRATED CONTINUOUS GLUCOSE MONITORING SYSTEM, FACTORY CALIBRATED, NOT FOR USE |
Manufacturer (Section D) |
ABBOTT DIABETES CARE INC. |
|
|
MDR Report Key | 16015147 |
MDR Text Key | 305819825 |
Report Number | MW5113853 |
Device Sequence Number | 1 |
Product Code |
QLG
|
Combination Product (y/n) | N |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Voluntary
|
Reporter Occupation |
Patient
|
Type of Report
| Initial |
Report Date |
11/02/2022 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 12/20/2022 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Lay User/Patient
|
Was Device Available for Evaluation? |
No
|
Patient Sequence Number | 1 |
Treatment | HUMALOG, LANTUS, X-RAY. |
Patient Outcome(s) |
Other;
|
Patient Age | 45 YR |
Patient Sex | Female |
Patient Ethnicity | Non Hispanic |
Patient Race | White |
|
|