FDA Adverse Event Malfunction Summary report: N

ACCU-CHEK COMFORT CURVE TEST STRIPS

MDR report key: 840680 · Received February 27, 2007

Report

Report Number
1823260-2007-01668
Event Type
Malfunction
Date Received
February 27, 2007
Date of Event
February 8, 2007
Report Date
February 27, 2007
Manufacturer
ROCHE DIAGNOSTICS
Product Code
LFR
PMA / PMN Number
K010362
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

SUSPECT DEVICE IS COMFORT CURVE TEST STRIPS.

Description of Event or Problem · 1

CUSTOMER REPORTEDLY OBTAINED RESULTS OF 256MG/DL AND 130MG/DL WITHIN 10 MINUTES ON THE ADVANTAGE TEST SYSTEM. NO ACTION WAS TAKEN BASED ON DEVICE RESULTS. NO ADVERSE EVENT REPORTED. REQUESTED RETURN OF SUSPECT TEST SYSTEM AND REPLACEMENT WAS SENT. NO INFO PRESENTED TO SUGGEST WHERE COMPARISON WAS PERFORMED. ADVANTAGE TEST SYSTEM: METER, STRIP LOT 549405, EXP 12/31/2007, CATALOG 2030373.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACCU-CHEK COMFORT CURVE TEST STRIPS BLOOD GLUCOSE MONITORING TEST STRIPS - LFR LFR ROCHE DIAGNOSTICS * 549405

Patients

Seq Age Sex Outcome Treatment
1 65 YR GLIPIZIDE 2 YEARS 5MG/1 TAB/1X A DAY| LISINOPRIL 2 YEARS 5 MG (AM) 10MG(PM)| ZOCOR 4 YEARS 20MG/1 TAB/1X A DAY