FDA Adverse Event Malfunction Summary report: N

ACCU-CHEK COMFORT CURVE TEST STRIPS

MDR report key: 841219 · Received February 28, 2007

Report

Report Number
1823260-2007-01713
Event Type
Malfunction
Date Received
February 28, 2007
Date of Event
February 9, 2007
Report Date
February 28, 2007
Manufacturer
ROCHE DIAGNOSTICS
Product Code
LFR
PMA / PMN Number
K010362
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

SUSPECT DEVICE: COMFORT CURVE TEST STRIPS.

Description of Event or Problem · 1

CUSTOMER REPORTEDLY OBTAINED RESULTS OF 396MG/DL AND 103MG/DL ON THE ADVANTAGE TEST SYSTEM WITHIN 10 MINUTES. NO ACTION WAS TAKEN BASED ON DEVICE RESULTS. NO ADVERSE EVENT REPORTED. NO QUALITY CONTROLS WERE USED. REQUESTED RETURN OF SUSPECT TEST SYSTEM AND REPLACEMENT WAS SENT. NO INFO PROVIDED ON LOCATION OF COMPARISON. ADVANTAGE TEST SYSTEM: METER, STRIP LOT 549421, EXP 01/31/2008, CAT/2030381.

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 * 549421

Patients

Seq Age Sex Outcome Treatment
1 83 YR COZAAR - 3 YRS 50MG ONCE DAILY| NEURONTIN - 3 YRS 400MG AT BED| NEURONTIN 3 YRS 100MG ONE PILL TWICE DA| LASIX 2-3 MONTHS 40MG ONCE DAILY| DICLOFENAC - 1 YR 75 TWICE DAILY| PRAVACHOL - 3 YRS 20MG ONCE DAILY| LEVOXYL 10+ YRS 88MCG ONCE DAILY