FDA Adverse Event Malfunction Summary report: N

ACCU-CHEK ® MULTICLIX

MDR report key: 3800025 · Received May 8, 2014

Report

Report Number
1823260-2014-03288
Event Type
Malfunction
Date Received
May 8, 2014
Date of Event
October 15, 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
CA
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 THE FIRST OF THE YEAR.

Description of Event or Problem · 1

REPORTER STATED LANCET PROTRUDES BEYOND THE END CAP OF THE MULTICLIX DEVICE. NO ACCIDENTAL STICK OR ADVERSE EVENT WAS REPORTED. THE MANUFACTURER REQUESTED RETURN OF SUSPECT PRODUCT FOR EVALUATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
279033 ACCU-CHEK ® MULTICLIX LANCET DEVICE FMK ROCHE DIAGNOSTICS NA GWU890

Patients

Seq Age Sex Outcome Treatment
1 NA Female