FDA Adverse Event Malfunction Summary report: N

ACCU-CHEK SPIRIT CARTRIDGE

MDR report key: 3011781 · Received March 19, 2013

Report

Report Number
2183996-2013-00410
Event Type
Malfunction
Date Received
March 19, 2013
Date of Event
March 11, 2013
Report Date
August 4, 2025
Manufacturer
ROCHE DIABETES CARE AG
Product Code
LZG
PMA / PMN Number
NA
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Health Professional
N

Narratives

Additional Manufacturer Narrative · 1

THE COMPLAINT DESCRIBING A LEAKAGE CANNOT BE VERIFIED. THE PRODUCT MEETS THE SPECIFICATIONS. ONE USED AND TEN UNUSED CARTRIDGES WERE VISUALLY, LEAK AND GLIDE FORCE TESTED. THE CARTRIDGES PASSED THE VISUAL TEST AND THE LEAKAGE TEST AT DIFFERENT POSITIONS OF THE PLUNGER ROD. THE GLIDE FORCE MEASURED IS IN ACCORDANCE WITH PRODUCT SPECIFICATIONS.

Additional Manufacturer Narrative · 1

THE INCIDENT OCCURRED OUTSIDE THE UNITED STATES. INFORMATION CONTAINED WITHIN THIS REPORT IS ALL THAT IS AVAILABLE AT THIS TIME. IF FURTHER INFORMATION IS OBTAINED, IT WILL BE PROVIDED IN THE SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

PATIENT REPORTED INSULIN LEAKED FROM THE CARTRIDGE. NO PHYSIOLOGICAL EFFECTS WERE REPORTED, AND SHE DID NOT REQUIRE TREATMENT FORM A HEALTHCARE PROFESSIONAL OR SECOND PARTY TO ADDRESS THE ISSUE. THE CARTRIDGE WAS REQUESTED FOR EVALUATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
114750 ACCU-CHEK SPIRIT CARTRIDGE INSULIN INFUSION PUMP CARTRIDGE LZG ROCHE DIABETES CARE AG 00700006871 32294312

Patients

Seq Age Sex Outcome Treatment
1 52 YR Female