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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Medline Industries, LP MEDLINE; METER,GLUCOSE,EVENCARE G3,PROF.USE ONLY

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Medline Industries, LP MEDLINE; METER,GLUCOSE,EVENCARE G3,PROF.USE ONLY Back to Search Results
Catalog Number MPH3540
Medical Device Problem Code Low Readings (2460)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/31/2023
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that "the meters keep running low in range when running controls - not in the range of numbers it shows it should be in.".
 
Additional Manufacturer Narrative
The customer stated that the meters keep running low in range when running controls and were not in the range of numbers it shows it should be in.A sample was not received for investigation; however, a lot number/serial number was recorded, and investigation included review of the lot/serial number and recent complaint trends/scar activity for the past 3 months.The complaint was not confirmed due to the fact that this issue can only be confirmed by further investigating the sample or a provided photo, and the documented cause was sample required to determine cause.No further action was taken because objectionable trends were not seen for this issue; division has been informed and will continue to monitor trends.There were no reports of death, serious injury, medical intervention, or follow up care.It has been determined that the reported event could cause or contribute to serious injury if it were to occur again.In an abundance of caution, this is a reportable event.If additional information becomes available this report will be reopened and reevaluated.This medical device report (mdr) is being submitted as part of retrospective review activities, which include review of historical data in accordance with regulations at 21 cfr part 803.The information included in this mdr reflects the information reasonably known to the manufacturer at the time of this retrospective review and submission.
 
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Brand Name
MEDLINE
Common Device Name
METER,GLUCOSE,EVENCARE G3,PROF.USE ONLY
Manufacturer (Section D)
Medline Industries, LP
three lakes drive
northfield IL 60093 -275
Manufacturer Contact
connor klawikowski
three lakes drive
northfield, IL 60093--275
MDR Report Key50872374
Report Number1417592-2026-49293
Device Sequence Number10674626
Product Code NBW
UDI-Device Identifier10884389831199
UDI-Public10884389831199
Combination Product (Y/N)N
Initial Reporter StateAZ
Initial Reporter CountryUS
PMA/510(K) Number
K120448
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Company Representative
Type of Report Initial
Report Date (Section B) 09/17/2026
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
Device Catalogue NumberMPH3540
Was Device Available for Evaluation? Yes
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/31/2023
Initial Report FDA Received Date09/23/2026
Was Device Evaluated by Manufacturer? (Y/N) No
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 Number1
Patient SexUnknown
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