BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ACCU-CHEK COMFORT CURVE TEST STRIPS

    MDR report key: 1781068 · Received July 25, 2007

    Report

    Report Number
    1823260-2007-06508
    Event Type
    Malfunction
    Date Received
    July 25, 2007
    Date of Event
    July 4, 2007
    Report Date
    July 25, 2007
    Manufacturer
    ROCHE DIAGNOSTICS
    Product Code
    LFR
    PMA / PMN Number
    K010362
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AZ, US
    Reporter Occupation
    LAY USER/PATIENT

    Narratives

    Description of Event or Problem · 1

    CUSTOMER REPORTEDLY OBTAINED A RESULT OF 357 MG/DL ON THE ADVANTAGE SYSTEM AND THE DOCTOR'S DEVICE READ 114 MG/DL WITHIN 10 MINUTES. NO ACTION TAKEN ON DEVICE RESULT. NO ADVERSE EVENT REPORTED DUE TO REPORTED RESULTS. 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 TEST STRIPS - LFR LFR ROCHE DIAGNOSTICS 549614

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR GLIPIZIDE - 2 YRS - 10MG/DAY| NOVOLIN R - 2 YRS - SLIDING SCALE| METFORMIN - 2 YRS - 1500MG/DAY