FDA Adverse Event Malfunction Summary report: N

ACCU-CHEK COMFORT CURVE TEST STRIPS

MDR report key: 857430 · Received March 6, 2007

Report

Report Number
1823260-2007-01945
Event Type
Malfunction
Date Received
March 6, 2007
Date of Event
February 17, 2007
Report Date
March 6, 2007
Manufacturer
ROCHE DIAGNOSTICS
Product Code
LFR
PMA / PMN Number
k010362
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, 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 600 MG/DL, 260 MG/DL, AND 258 MG/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. NO INDICATION GIVEN AS TO WHERE COMPARISON PERFORMED. REQUESTED RETURN OF SUSPECT TEST SYSTEM AND REPLACEMENT WAS SENT. NO INFO PROVIDED FOR WHERE COMPARISON WAS PERFORMED. ADVANTAGE TEST SYSTEM: METER, STRIP LOT 549522, EXP 02/29/2008, 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 * 549522

Patients

Seq Age Sex Outcome Treatment
1 71 YR HYDROLOZINE-1 YR 25MG/2X DAY| METFORMIN-1 YR 850MG 2X DAY| LISINOPRIL-1 YR 40MG/1X DAY| FLUOXETINE-1 YR 20MG/1X DAY| LOVASTATIN-1 YR 40MG/1X DAY| NAMANDA-1 YR 10MG/2X DAY| PLAVIX-6 MONTHS 75MG/1X DAY| PROTONIX-1 YR 40MG/1X DAY| NIFEDIPINE-1 YR 30MG/1X DAY| ASPIRIN-1 YR 81MG/1X DAY| GLIPIZIDE-1 YR 5MG 2 X DAY