BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SOFTCLIX LANCET DEVICE

    MDR report key: 1191533 · Received September 26, 2008

    Report

    Report Number
    1823260-2008-07201
    Event Type
    Malfunction
    Date Received
    September 26, 2008
    Date of Event
    September 24, 2008
    Report Date
    September 26, 2008
    Manufacturer
    ROCHE DAIGNOTICS
    Product Code
    FMK
    PMA / PMN Number
    EXEMPT
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    LAY USER/PATIENT

    Narratives

    Description of Event or Problem · 1

    THE REPORTER STATED THAT THE LANCETS DID NOT RETRACT. SHE DID NOT CONFIRM IF THIS OCCURRED BEFORE OR AFTER FIRING THE LANCET DEVICE. NO ACTION TAKEN OR TREATMENT GIVEN BASED ON THE LANCET DEVICE ISSUE. NO ACCIDENTAL STICK OR ADVERSE EVENT REPORTED. NEW LANCET DEVICE WITH LANCETS SENT AND RETURN REQUESTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SOFTCLIX LANCET DEVICE LANCET DEVICE - FMK FMK ROCHE DAIGNOTICS

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK