BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ACCU-CHEK ® COMFORT CURVE TEST STRIPS

    MDR report key: 2232863 · Received September 2, 2011

    Report

    Report Number
    1823260-2011-04710
    Event Type
    Malfunction
    Date Received
    September 2, 2011
    Date of Event
    August 8, 2011
    Report Date
    November 2, 2011
    Manufacturer
    ROCHE DIAGNOSTICS
    Product Code
    LFR
    PMA / PMN Number
    K010362
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    REPORTER ALLEGED OBTAINING THE RESULTS OF 320 MG/DL, 292 MG/DL AND 135 MG/DL BACK TO BACK WITHIN 10 MINUTES ON THE ADVANTAGE SYSTEM. NO ACTIONS WERE REPORTED TAKEN OR TREATMENT RECEIVED. NO ADVERSE EVENT REPORTED. A REQUEST WAS MADE FOR THE RETURN OF THE AFFECTED PRODUCT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ACCU-CHEK ® COMFORT CURVE TEST STRIPS BLOOD GLUCOSE MONITORING TEST STRIPS LFR ROCHE DIAGNOSTICS NA 551478

    Patients

    Seq Age Sex Outcome Treatment
    1 075 YR FERROUS SULFATE (DAILY)| COREG (TWICE DAILY)| CALCIUM (TWICE DAILY)| VYTORIN 1040 (DAILY)| DIOVAN| LASIX (DAILY)| LEVOTHYROXINE (DAILY)| ECOTRIN (DAILY)| VITAMIN D (DAILY)| ISOSORBIDE (DAILY)| GEMFIBROZIL (DAILY)| NOVOLOG| OMEPRAZOLE (DAILY)