BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ACCU-CHEK COMFORT CURVE TEST STRIPS

    MDR report key: 1191504 · Received September 26, 2008

    Report

    Report Number
    1823260-2008-07188
    Event Type
    Malfunction
    Date Received
    September 26, 2008
    Date of Event
    September 17, 2008
    Report Date
    September 26, 2008
    Manufacturer
    ROCHE DIAGNOSTICS
    Product Code
    LFR
    PMA / PMN Number
    K010362
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    LAY USER/PATIENT

    Narratives

    Description of Event or Problem · 1

    CUSTOMER REPORTED BLOOD GLUCOSE RESULTS OF HI, WHICH ON THE ADVANTAGE SYSTEM INDICATES A RESULT IN EXCESS OF 600 MG/DL, ON THE ADVANTAGE SYSTEM, 142 MG/DL AND 139 MG/DL WITHIN 10 MINUTES ON A PROFRESSIONAL SYSTEM. CUSSTOEMR REPORTED NO SYMPTOMS, DID NOT TREAT OR ACT ON RESULTS. NO ADVERES 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 550090

    Patients

    Seq Age Sex Outcome Treatment
    1 35 YR FENOFIBRATE 145 MG/DAY| PROVENTIL| CETIRIZINE| NOVOLIN N SLIDING SCALE| IMITREX| PREVACID 30 MG/DAY| MELOXICAM 15 MG/DAY| HYDROMORPHONE 5.5 MG/HOUR| SIMVASTATIN 40 MG/DAY| LISINOPRIL 40 MG/DAY| VITAMIN D 50000 UNITS/WEEK| METFORMIN 2000 MG/DAY| ASPART PUMP 3.95 UNITS/HOUR