FDA Adverse Event Malfunction Summary report: N

ACCU-CHEK COMFORT CURVE TEST STRIPS

MDR report key: 1011728 · Received March 11, 2008

Report

Report Number
1823260-2008-02305
Event Type
Malfunction
Date Received
March 11, 2008
Date of Event
February 22, 2008
Report Date
March 11, 2008
Manufacturer
ROCHE DIAGNOSTICS
Product Code
LFR
PMA / PMN Number
K010362
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
LAY USER/PATIENT

Narratives

Description of Event or Problem · 1

CUSTOMER REPORTEDLY RECEIVED THE FOLLOWING RESULTS ON THE ADVANTAGE SYSTEM WITHIN 10 MINUTES: 86 MG/DL, 429 MG/DL, AND 126 MG/DL. NO ACTIONS TAKEN BASED ON DEVICE RESULTS. NO ADVERSE EVENT REPORTED. REQUESTED RETURN OF SUSPECT DEVICE AND REPLACEMENT WAS SENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACCU-CHEK COMFORT CURVE TEST STRIPS BLOOD GLUCOSE MONITORING TEST STRIPS - LFR LFR ROCHE DIAGNOSTICS 549616

Patients

Seq Age Sex Outcome Treatment
1 49 YR LEXAPRO 10MG 1/DAY - 2 YEARS| MAXZIDE 25MG 1/DAY - YEARS| OMEPRAZOLE 20MG 1/DAY - YEARS| ALBUTEROL AS NEEDED - YEARS| ADVAIR 250/50 INHALER 2/DAY - YEARS| "SPIRIDA" "INHALE CAPSULE" - YEARS| "BUSPIRONE-HC" 30MG 2/DAY - YEARS| CRESTOR 20MG 1/DAY - 2 YEARS| LISINOPRIL 10MG 1/DAY - 3 1/2 YEARS| THEOPHYLLINE 400MG 3/DAY - YEARS| DETROL-LA 4MG 1/DAY - 5 YEARS| "NORETHIN ACE" 5MG 1/DAY - 3 YEARS| LORATADINE 10MG 1/DAY - YEARS| GLIPIZIDE 10MG IN AM - 4-5 YEARS| METFORMIN 500MG 2TABS 2/DAY - 4-5 YEARS| POTASSIUM CHLORIDE 10MEQ - 2/DAY 2 YEARS| FUROSEMIDE 40MG 1/DAY - YEARS