FDA Adverse Event Malfunction Summary report: N

ACCU-CHEK COMFORT CURVE TEST STRIPS

MDR report key: 842287 · Received February 27, 2007

Report

Report Number
1823260-2007-01675
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 STRIP.

Description of Event or Problem · 1

CUSTOMER REPORTEDLY OBTAINED A RESULT OF 248 MG/DL ON ADVANTAGE TEST SYSTEM 1 AND 112 MG/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. INFORMATION SUGGESTS COMPARISON WAS PERFORMED IN THE HOME. ADVANTAGE TEST SYSTEM 1: METER, STRIP LOT 548738, EXP 02/28/2007, CAT/ 2030373. ADVANTAGE TEST SYSTEM 2: METER, STRIP LOT 549561, EXP 03/31/2008, 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 * 2/28/2007

Patients

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