BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ACCU-CHEK COMFORT CURVE TEST STRIPS

    MDR report key: 842449 · Received February 28, 2007

    Report

    Report Number
    1823260-2007-01712
    Event Type
    Malfunction
    Date Received
    February 28, 2007
    Date of Event
    January 8, 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
    NY, 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 480MG/DL AND 87MG/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 INFORMATION PROVIDED ON WHERE COMPARISON WAS PERFORMED. ADVANTAGE TEST SYSTEM: METER, STRIP LOT 549618, EXP 4/30/08, CAT/2030365.

    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 * 549618

    Patients

    Seq Age Sex Outcome Treatment
    1 70 YR ADVANTA - 2 YEARS 8 MG 1X/DAY| DIOXIN - 3 YEARS 8MG 1X/DAY| METFORMIN - 10 YEARS 850 MG 3X/DAY| NOVOLIN 70/30 - NOT QUITE A YEAR 26 UNITS IN AM| ASPIRIN - 1 YEARS 81 MG 1X/DAY