| Brand Name | ACCU-CHEK ® GUIDE ME |
| Common Device Name | BLOOD GLUCOSE MONITORING DEVICE |
| Manufacturer (Section D) |
| ROCHE DIABETES CARE, INC. |
| 9115 hague road |
| indianapolis IN 46250 0457 |
|
| Manufacturer (Section G) |
| ALTEK MEDICAL (KUNSHAN) LTD. |
| na77, 3rd main street |
| jiangsu province |
| kunshan |
|
CH
|
|
| Manufacturer Contact |
|
natalie
catton
|
| 9115 hague road |
| na |
| indianapolis, IN 46250-0457
|
|
| MDR Report Key | 24813003 |
| Report Number | 3011393376-2026-00219 |
| Device Sequence Number | 9686871 |
| Product Code |
NBW
|
| UDI-Device Identifier | 00365702702431 |
| UDI-Public | 00365702702431 |
| Combination Product (Y/N) | N |
| Initial Reporter State | TN |
| Initial Reporter Country | US |
| PMA/510(K) Number | K181131 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Consumer |
| Initial Reporter Occupation |
Other
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
05/06/2026 |
| 1 Device was Involved in the Event |
|
| 1 Patient was Involved in the Event |
|
| Is this an Adverse Event Report? |
No
|
| Is this a Product Problem Report? |
Yes
|
| Operator of Device |
Lay User/Patient
|
| Device Catalogue Number | 08387052001 |
| Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Follow-Up |
| Initial Date Received by Manufacturer | 03/10/2026 |
| Supplement Date Received by Manufacturer | 05/05/2026
|
| Initial Report FDA Received Date | 04/08/2026 |
| Supplement Report FDA Received Date | 05/06/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Is the Device Labeled for Single Use? (Y/N) |
No
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Patient Age | 51 YR |
| Patient Sex | Male |
|
|