COAGUCHEK ? XS SYSTEM 04625374160

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer report with the FDA on 2020-03-19 for COAGUCHEK ? XS SYSTEM 04625374160 manufactured by Roche Diagnostics.

MAUDE Entry Details

Report Number1823260-2020-00774
MDR Report Key9852487
Report SourceCONSUMER
Date Received2020-03-19
Date of Report2020-03-19
Date of Event2020-02-24
Date Mfgr Received2020-02-24
Date Added to Maude2020-03-19
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactNA MICHAEL LESLIE
Manufacturer Street9115 HAGUE ROAD NA
Manufacturer CityINDIANAPOLIS IN 46250
Manufacturer CountryUS
Manufacturer Postal46250
Manufacturer Phone3175214343
Manufacturer G1ROCHE DIAGNOSTICS GMBH
Manufacturer StreetSANDHOFERSTRASSE 116 NA
Manufacturer CityMANNHEIM (BADEN-WURTTEMBERG) 68305
Manufacturer CountryGM
Manufacturer Postal Code68305
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameCOAGUCHEK ? XS SYSTEM
Generic NamePROTHROMBIN TIME TEST STRIPS
Product CodeGJS
Date Received2020-03-19
Returned To Mfg2020-03-03
Model NumberNA
Catalog Number04625374160
Lot Number41747423
OperatorLAY USER/PATIENT
Device AvailabilityR
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerROCHE DIAGNOSTICS
Manufacturer Address9115 HAGUE ROAD INDIANAPOLIS IN 462500457 US 462500457


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-19

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