| Brand Name | FreeStyle Libre 3 |
| Common Device Name | Continuous Glucose Monitoring System |
| Manufacturer (Section D) |
| Abbott Diabetes Care Ltd |
| range road |
| witney 12345 -700 |
| UK 12345-7001 |
|
| Manufacturer Contact |
|
melissa
pieplow
|
| 1360 south loop road |
| alameda, CA 94502--700
|
|
+1(510)384-5975
|
|
| MDR Report Key | 50703537 |
| Report Number | 2954323-2026-397292 |
| Device Sequence Number | 5891598 |
| Product Code |
QBJ
|
| UDI-Device Identifier | 30357599819003 |
| UDI-Public | (01)30357599819003(17)2024-02-29(10)T60001176(91)72080-01 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | GM |
| PMA/510(K) Number | K223435 |
| 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 |
| Report Date (Section B) |
09/09/2026 |
| 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 Expiration Date | 02/29/2024 |
| Device Model Number | 72081-01 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 10/24/2023 |
| Initial Report FDA Received Date | 09/10/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 08/14/2023 |
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |