FDA Adverse Event Malfunction Summary report: N

ACCU-CHECK COMFORT CURVE TEST STRIPS

MDR report key: 1022632 · Received March 31, 2008

Report

Report Number
1823260-2008-02865
Event Type
Malfunction
Date Received
March 31, 2008
Date of Event
March 24, 2008
Report Date
March 31, 2008
Manufacturer
ROCHE DIAGNOSTICS
Product Code
LFR
PMA / PMN Number
K010362
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS MEDWATCH IS FOR THE SUSPECT DEVICE USED IN INFORM SYSTEM #1. PLEASE SEE MEDWATCH WITH PT IS FOR SUSPECT DEVICE IN INFORM #2.

Description of Event or Problem · 1

CALLER REPORTS BACK TO BACK RESULTS OF 532 MG/DL ON INFORM SYSTEM #1 COMPARED TO RESULTS OF 176 MG/DL ON INFORM SYSTEM #2. CALLER REPORTS PT WAS TREATED BASED ON METER #2 RESULTS OF 176 MG/DL; TREATMENT WAS NOT PROVIDED. CALLER REPORTS QUALITY CONTROLS WERE RUN AND IN RANGE. NO ADVERSE EVENT REPORTED. CALLER REPORTS THERE ARE NO STRIPS TO RETURN; A REPLACEMENT WAS SENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACCU-CHECK COMFORT CURVE TEST STRIPS BLOOD GLUCOSE MONITORING TEST STRIPS - LFR LFR ROCHE DIAGNOSTICS 550528

Patients

Seq Age Sex Outcome Treatment
1 85 YR GLYBURIDE - 2.5MG AM| COUMADIN - 5MG DAILY| NOVOLOG SLIDING SCALE AC/HS| KEPPRA - 500MG 2X/DAY| MULTIVITAMIN - DAILY| FOLIC ACID - 1 MG DAILY| SEROQUEL - 100MG 3X/DAY| CARAFATE - 1G 3X/DAY| LOPRESSOR - 12.5MG 2X/DAY