FDA Adverse Event Malfunction Summary report: N

ACCU-CHEK COMFORT CURVE TEST STRIPS

MDR report key: 1040978 · Received May 8, 2008

Report

Report Number
1823260-2008-03849
Event Type
Malfunction
Date Received
May 8, 2008
Date of Event
April 21, 2008
Report Date
May 8, 2008
Manufacturer
ROCHE DIAGNOSTICS
Product Code
LFR
PMA / PMN Number
K010362
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
LAY USER/PATIENT

Narratives

Description of Event or Problem · 1

CUSTOMER REPORTEDLY RECEIVED RESULT OF 520 MG/DL ON THE ADVANTAGE SYSTEM AND 121 MG/DL ON PROFESSIONAL METER WITHIN 10 MINUTES. 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 550051

Patients

Seq Age Sex Outcome Treatment
1 77 YR BABY ASPIRIN - 81MG 1/DAY| RANITIDINE - 150MG 2/DAY| ATENOLOL - 50MG 2/DAY| PLAVIX - 75MG 1 EVERY OTHER DAY| B12 - 2MG 1/DAY| "TRIANT" HCTZ - 37.5/25 1/DAY