BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ACCU-CHEK COMFORT CURVE TEST STRIPS

    MDR report key: 1110486 · Received August 14, 2008

    Report

    Report Number
    1823260-2007-05281
    Event Type
    Malfunction
    Date Received
    August 14, 2008
    Date of Event
    May 25, 2007
    Report Date
    June 15, 2007
    Manufacturer
    ROCHE DIAGNOSTICS
    Product Code
    LFR
    PMA / PMN Number
    K010362
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MI, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    CALLER REPORTEDLY REC'D A RESULT OF APPROX 200 MG/DL ON THE ADVANTAGE SYSTEM AND 104 MG/DL ON THE DR'S DEVICE WITHIN 10 MINUTES. NO ACTION TAKEN ON 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 DEVICE - LFR LFR ROCHE DIAGNOSTICS 549705

    Patients

    Seq Age Sex Outcome Treatment
    1 68 YR