FDA Adverse Event Malfunction Summary report: N

ACCU-CHEK ® MULTICLIX

MDR report key: 4200031 · Received October 24, 2014

Report

Report Number
1823260-2014-08240
Event Type
Malfunction
Date Received
October 24, 2014
Date of Event
September 29, 2014
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).

Description of Event or Problem · 1

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

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
678164 ACCU-CHEK ® MULTICLIX LANCET DEVICE FMK ROCHE DIAGNOSTICS NA WPX025

Patients

Seq Age Sex Outcome Treatment
1 NA Female