FDA Adverse Event Malfunction Summary report: N

ACCU-CHEK COMFORT CURVE TEST STRIPS

MDR report key: 854734 · Received March 2, 2007

Report

Report Number
1823260-2007-01786
Event Type
Malfunction
Date Received
March 2, 2007
Date of Event
January 16, 2007
Report Date
March 2, 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 A RESULT OF 105MG/DL ON THE ADVANTAGE TEST SYSTEM AND 228MG/DL ON THE DOCTOR'S METER WITHIN 10 MINUTES. NO ACTION WAS TAKEN BASED ON DEVICE RESULT. NO ADVERSE EVENT REPORTED. REQUESTED RETURN OF SUSPECT TEST SYSTEM AND REPLACEMENT WAS SENT. INFORMATION SUGGESTS COMPARISON WAS PERFORMED AT THE DOCTOR'S OFFICE. ADVANTAGE TEST SYSTEM: METER, STRIP LOT 549226, EXP 10/31/07, 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 * 549226

Patients

Seq Age Sex Outcome Treatment
1 86 YR LIPITOR - 5 YRS 10MG ONCE A DAY| AVANDIA - 5 YRS 4MG ONCE A DAY| POTASSIUM - 5 YRS 10MG ONCE A DAY| COZAAR - 5 YRS 25MG ONCE A DAY