FDA Adverse Event Malfunction Summary report: N

ACCU-CHEK ® MULTICLIX

MDR report key: 3030814 · Received April 2, 2013

Report

Report Number
1823260-2013-01975
Event Type
Malfunction
Date Received
April 2, 2013
Date of Event
March 6, 2013
Report Date
July 28, 2025
Manufacturer
ROCHE DIAGNOSTICS
Product Code
FMK
PMA / PMN Number
EXEMPT
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Health Professional
N

Narratives

Additional Manufacturer Narrative · 1

THE EVENT OCCURRED IN (B)(6). THE YEAR IS THE ONLY KNOWN PART OF MANUFACTURE DATE. WE HAVE DEFAULTED TO (B)(6).

Description of Event or Problem · 1

MANUFACTURER'S INVESTIGATIONAL UNIT CONFIRMED THE LANCET PROTRUDES BEYOND THE END CAP OF THE MULTICLIX DEVICE. SUSPECT DEVICE HAS BEEN RETURNED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
133621 ACCU-CHEK ® MULTICLIX LANCET DEVICE FMK ROCHE DIAGNOSTICS NA WPY010

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown