BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ACCU-CHEK ® FASTCLIX

    MDR report key: 3920109 · Received July 8, 2014

    Report

    Report Number
    1823260-2014-04990
    Event Type
    Malfunction
    Date Received
    July 8, 2014
    Date of Event
    June 16, 2014
    Report Date
    July 30, 2025
    Manufacturer
    ROCHE DIAGNOSTICS
    Product Code
    FMK
    PMA / PMN Number
    EXEMPT
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FR
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
    Health Professional
    N

    Narratives

    Additional Manufacturer Narrative · 1

    THE EVENT OCCURRED IN (B)(6).

    Description of Event or Problem · 1

    CALLER REPORTS LANCET PROTRUDES BEYOND THE END CAP OF THE FASTCLIX DEVICE AND REMAINS IN THE FINGER. NO ADVERSE EVENT REPORTED. REQUESTED RETURN OF SUSPECT DEVICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    396226 ACCU-CHEK ® FASTCLIX LANCET DEVICE FMK ROCHE DIAGNOSTICS NA GRZ005

    Patients

    Seq Age Sex Outcome Treatment
    1 41 YR Female