FDA Adverse Event Injury Summary report: N

ACCU-CHEK ADVANTAGE

MDR report key: 1020033 · Received March 27, 2008

Report

Report Number
1823260-2008-02831
Event Type
Injury
Date Received
March 27, 2008
Date of Event
March 9, 2008
Report Date
March 27, 2008
Manufacturer
ROCHE DIAGNOSTICS
Product Code
CGA
PMA / PMN Number
K930979
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
LAY USER/PATIENT

Narratives

Description of Event or Problem · 1

CUSTOMER REPORTS BEING UNABLE TO TEST HER BLOOD GLUCOSE FOR 2 DAYS ON THE ADVANTAGE SYSTEM BECAUSE OF POWER ISSUE. CUSTOMER REPORTS ON THE DAY OF THE INCIDENT SHE ATTEMPTED TO TEST HER BLOOD GLUCOSE WHILE HAVING HIGH BLOOD SYMPTOMS, BUT WAS UNABLE TO OBTAIN A RESULT (STATES SHE WOULD HAVE TREATED HERSELF WITH INSULIN SHE HAD KNOWN THE RESULT). SHE WAS TAKEN TO THE HOSPITAL AND ADMITTED FOR HIGH BLOOD AND CONGESTIVE HEART FAILURE. CUSTOMER WAS RELEASED FROM THE HOSPITAL 5 DAYS LATER. REQUESTED RETURN OF SUSPECT DEVICE AND REPLACEMENT WAS SENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACCU-CHEK ADVANTAGE BLOOD GLUCOSE MONITORING DEVICE - CGA CGA ROCHE DIAGNOSTICS

Patients

Seq Age Sex Outcome Treatment
1 76 YR Hospitalization NOVOLIN 70/30 10 UNITS PM - APPROX 25 YEARS| NOVOLIN 70/30 40 UNITS AM - APPROX 25 YEARS