FDA Adverse Event Malfunction Summary report: N

SOFTCLIX LANCET DEVICE

MDR report key: 1052267 · Received May 6, 2008

Report

Report Number
1823260-2008-03766
Event Type
Malfunction
Date Received
May 6, 2008
Date of Event
May 1, 2008
Report Date
May 6, 2008
Manufacturer
ROCHE DIAGNOSTICS
Product Code
FMK
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
LAY USER/PATIENT

Narratives

Description of Event or Problem · 1

CALLER STATES, THE LANCET DOES NOT RETRACT INTO THE SOFTCLIX LANCET DEVICE. 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 SOFTCLIX LANCET DEVICE LANCET DEVICE - FMK FMK ROCHE DIAGNOSTICS WIP071

Patients

Seq Age Sex Outcome Treatment
1 62 YR