| Brand Name | FreeStyle Lite |
| Common Device Name | System, Test, Blood Glucose, Over The Counter |
| Manufacturer (Section D) |
| Abbott Diabetes Care Inc |
| 1360 south loop road |
| alameda CA 94502 -700 |
|
| Manufacturer Contact |
|
melissa
pieplow
|
| 1360 south loop road |
| alameda, CA 94502--700
|
|
+1(510)384-5975
|
|
| MDR Report Key | 50560885 |
| Report Number | 2954323-2026-327348 |
| Device Sequence Number | 10495812 |
| Product Code |
NBW
|
| UDI-Device Identifier | 00699073708052 |
| UDI-Public | (01)00699073708052(10)01Z129D(17)221231 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | US |
| PMA/510(K) Number | K092602 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Consumer |
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
09/28/2026 |
| 1 Device was Involved in the Event |
|
| 1 Patient was Involved in the Event |
|
| Is this an Adverse Event Report? |
No
|
| Is this a Product Problem Report? |
Yes
|
| Operator of Device |
Lay User/Patient
|
| Device Model Number | 70805-70 |
| Was Device Available for Evaluation? |
Yes
|
| Date Returned to Manufacturer | 09/10/2026 |
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 08/11/2026 |
| Supplement Date Received by Manufacturer | 09/10/2026
|
| Initial Report FDA Received Date | 09/02/2026 |
| Supplement Report FDA Received Date | 09/28/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 12/10/2018 |
| Is the Device Labeled for Single Use? (Y/N) |
No
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Patient Sequence Number | 1 |
| Patient Age | 74 YR |
| Patient Sex | Unknown |
| Patient Weight | 341 LB |
|
|