BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ACCU-CHEK COMPACT TEST DRUM

    MDR report key: 1011741 · Received March 11, 2008

    Report

    Report Number
    1823260-2008-02323
    Event Type
    Malfunction
    Date Received
    March 11, 2008
    Date of Event
    February 26, 2008
    Report Date
    March 11, 2008
    Manufacturer
    ROCHE DIAGNOSTICS
    Product Code
    LFR
    PMA / PMN Number
    K031755
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    REPORTER ALLEGED OBTAINING DISCREPANT BLOOD GLUCOSE RESULTS OF 204 MG/DL BACK TO BACK WITH A RESULT OF 24 MG/DL WHEN TESTING WAS PERFORMED WITHIN 4 MINUTES OF EACH OTHER ON THE COMPACT SYSTEM. NO ACTIONS WERE REPORTED TAKEN OR TREATMENT WAS RECEIVED. A REQUEST WAS MADE FOR THE RETURN OF THE SUSPECT DEVICE AND REPLACEMENT PRODUCT WAS SENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ACCU-CHEK COMPACT TEST DRUM BLOOD GLUCOSE MONITORING TEST STRIPS - LFR LFR ROCHE DIAGNOSTICS 20663541

    Patients

    Seq Age Sex Outcome Treatment
    1 49 YR SYNTHROID 0.1MG ONCE DAILY| METFORMIN 1000 MG| HEMOCYTE PLUS| FEXOFENADINE| JANUVIA