FDA Adverse Event
Malfunction
Summary report: N
ACCU-CHEK ® FASTCLIX
MDR report key: 3071150
·
Received April 22, 2013
Report
- Report Number
- 1823260-2013-02455
- Event Type
- Malfunction
- Date Received
- April 22, 2013
- Date of Event
- March 26, 2013
- Report Date
- July 29, 2025
- Manufacturer
- ROCHE DIAGNOSTICS
- Product Code
- FMK
- PMA / PMN Number
- EXEMPT
- Removal / Correction Number
- NA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- AZ, US
- Reporter Occupation
- PATIENT
- Health Professional
- N
Narratives
Additional Manufacturer Narrative · 1
IT WAS UNKNOWN IF THE INITIAL REPORTER SENT REPORT TO THE FDA. THE YEAR IS THE ONLY KNOWN PART OF MANUFACTURE DATE. WE HAVE DEFAULTED TO THE FIRST OF THE YEAR.
Description of Event or Problem · 1
CALLER REPORTS LANCET PROTRUDES BEYOND THE END CAP OF THE FASTCLIX DEVICE. CALLER STATES THAT THE NEEDLE PRICKED HER FINGER. NO MEDICAL ATTENTION NEEDED OR SOUGHT. NO ADVERSE EVENT REPORTED. REQUESTED RETURN OF SUSPECT DEVICE AND REPLACEMENT WAS SENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 171677 | ACCU-CHEK ® FASTCLIX | LANCET DEVICE | FMK | ROCHE DIAGNOSTICS | NA | GDZ024 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Female |