FDA Adverse Event Malfunction Summary report: N

ACCU-CHEK COMPACT TEST DRUM

MDR report key: 1770534 · Received October 25, 2007

Report

Report Number
1823260-2007-09214
Event Type
Malfunction
Date Received
October 25, 2007
Date of Event
October 5, 2007
Report Date
October 22, 2007
Manufacturer
ROCHE DIAGNOSTICS
Product Code
LFR
PMA / PMN Number
K031755
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
LAY USER/PATIENT

Narratives

Description of Event or Problem · 1

CUSTOMER REPORTS BACK TO BACK TESTING ON THE SAME METER WHILE USING THE COMPACT PLUS SYSTEM WITH RESULTS OF HI (>600MG/DL) AND 229MG/DL. NO QUALITY CONTROLS WERE RUN DURING THE CALL. NO ADVERSE EVENT REPORTED. A REQUEST WAS MADE FOR RETURN OF SUSPECT PRODUCT AND REPLACEMENT WAS SENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACCU-CHEK COMPACT TEST DRUM BLOOD GLUCOSE MONITORING TEST STRIPS - LFR LFR ROCHE DIAGNOSTICS

Patients

Seq Age Sex Outcome Treatment
1 62 YR HUMALOG| DARVOCET| ALLOPURINOL| HUMULIN| PHENAZOPYRIDINE