FDA Adverse Event Malfunction Summary report: N

ACCU-CHEK COMFORT CURVE TEST STRIPS

MDR report key: 872116 · Received March 21, 2007

Report

Report Number
1823260-2007-02281
Event Type
Malfunction
Date Received
March 21, 2007
Date of Event
February 24, 2007
Report Date
March 21, 2007
Manufacturer
ROCHE DIAGNOSTICS CORP.
Product Code
LFR
PMA / PMN Number
K010362
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AR, 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 52MG/DL, 110MG/DL, AND 64MG/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. INFORMATION NOT PROVIDED ON WHERE COMPARISON OCCURRED. ADVANTAGE TEST SYSTEM: METER, STRIP LOT 549627, EXPIRATION DATE 05/31/2008, CATALOG 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 CORP. * 549627

Patients

Seq Age Sex Outcome Treatment
1 58 YR METFORMIN - 5YRS 1000MG/ 2X A DAY| LANTUS - 1YR 40CC'S| AMARYL - 5YRS 4MG/ 2X A DAY