FDA Adverse Event Malfunction Summary report: N

ACCU-CHEK COMFORT CURVE TEST STRIPS

MDR report key: 841614 · Received February 27, 2007

Report

Report Number
1823260-2007-01674
Event Type
Malfunction
Date Received
February 27, 2007
Date of Event
February 11, 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
MN, US
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

SUSPECT DEVICE IS COMFORT CURVE STRIPS LOT 549561.

Description of Event or Problem · 1

CUSTOMER REPORTEDLY OBTAINED A RESULT OF 248MG/DL ON ADVANTAGE TEST SYSTEM 1 AND 112MG/DL ON ADVANTAGE TEST SYSTEM 2. NO ACTION WAS TAKEN BASED ON DEVICE RESULTS. NO ADVERSE EVENT REPORTED. REQUESTED RETURN OF SUSPECT TEST SYSTEM AND REPLACEMENT WAS SENT. INFO SUGGESTS COMPARISON WAS PERFORMED IN THE HOME. ADVANTAGE TEST SYSTEM 1: STRIP LOT 548738, EXP 2/28/07. CAT/2030373. ADVANTAGE TEST SYSTEM 2: METER 8123603399, STRIP LOT 549561 EXP 3/31/08, CAT/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 * 549561

Patients

Seq Age Sex Outcome Treatment
1 57 YR GLIPIZIDE - 10 YRS. 5MG/1X DAY| METFORMIN - 10 YEARS. 1000MG/2X DAY| ACTOS - 5 YRS. 30 MG/1X DAY