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