FDA Adverse Event Malfunction Summary report: N

ACCU-CHEK COMFORT CURVE TEST STRIPS

MDR report key: 1063593 · Received June 20, 2008

Report

Report Number
1823260-2008-04882
Event Type
Malfunction
Date Received
June 20, 2008
Date of Event
June 17, 2008
Report Date
June 20, 2008
Manufacturer
ROCHE DIAGNOSTICS
Product Code
LFR
PMA / PMN Number
K010362
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

CUSTOMER REPORTED METER RESULTS OF 426 MG/DL AND 175 MG/DL WITHIN 10 MINUTES ON THE INFORM SYSTEM. CUSTOMER REPORTED NO PATIENT SYMPTOMS, DID NOT TREAT OR ACT ON RESULTS. NO ADVERSE EVENT REPORTED. A REQUEST WAS MADE FOR THE RETURN OF THE SYSTEM, 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 549731

Patients

Seq Age Sex Outcome Treatment
1 81 YR PROCHLOPRERAZINE 26MG/DAY - 4 MONTHS| LISINOPRIL 40MG/DAY - 11 MONTHS| NIFEDIPINE 90MG/DAY - 11 MONTHS| LEXAPRO - 5MG/DAY| CARBAMAZEPINE 100MG/DAY - 4 MONTHS| ACETAMINOPHEN 325MG/DAY - 5 MONTHS| FLOMAX CAP 0.4MG/DAY - 11 MONTHS| BISACODYL 5MG/DAY - 11 MONTHS| ASPIRIN 81MG/DAY - 11 MONTHS| FUROSEMIDE - 2 MONTHS| CERTAGEN - 10 MONTHS| GLIPIZIDE - 10MG/DAY| POTASSIUM CHLORIDE - 10MEQ/DAY - 11 MONTHS| LIPITOR 10MG/DAY - 11 MONTHS| ARICEPT 5MG/DAY - 2 MONTHS| NAPROXEN 250MG/DAY - 11 MONTHS