BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ACCU-CHEK COMFORT CURVE TEST STRIPS

    MDR report key: 1060093 · Received June 11, 2008

    Report

    Report Number
    1823260-2008-04630
    Event Type
    Malfunction
    Date Received
    June 11, 2008
    Date of Event
    June 4, 2008
    Report Date
    June 11, 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

    Description of Event or Problem · 1

    CUSTOMER REPORTEDLY OBTAINED A RESULT OF 249 MG/DL ON THE ADVANTAGE SYSTEM WHILE A PROFESSIONAL DEVICE PRODUCED A RESULT OF 49 MG/DL WITHIN 10 MINS. CUSTOMER ATE IN RESPONSE TO SYMPTOMS AND PROFESSIONAL DEVICE RESULT. NO ADVERSE EVENT REPORTED. REQUESTED RETURN OF SUSPECT SYSTEM 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 550054

    Patients

    Seq Age Sex Outcome Treatment
    1 14 YR HUMALOG - 10 YRS| HUMULIN N - 10 YRS