FDA Adverse Event Injury Summary report: N

NOVOFINE 31G

MDR report key: 1015018 · Received March 18, 2008

Report

Report Number
9681821-2008-00014
Event Type
Injury
Date Received
March 18, 2008
Date of Event
January 18, 2008
Report Date
February 18, 2008
Manufacturer
NOVO NORDISK A/S, MEDICAL SYSTEMS
Product Code
FMI
PMA / PMN Number
K002403
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

EVENT VERBATIM [PREFERRED TERM] (RELATED SYMPTOMS IF ANY SEPARATED BY COMMAS). PEN NOT EXPELLING INSULIN [DEVICE FAILURE] ([DIABETIC KETOACIDOSIS]). CASE DESCRIPTION: MEDICAL DEVICE INFORMATION: NOVOPEN 3 AND NOVOPEN 3 PENMATE: CLASS LLB. NOVOFINE 31G: CLASS LLA. THIS SPONTANEOUS REPORT, RECEIVED FROM UNITED KINGDOM AND REPORTED BY A CONSUMER AS "DIABETIC KETOACIDOSIS AND DEVICE FAILURE", CONCERNS A PATIENT (GENDER AND AGE UNKNOWN) TREATED WITH MIXTARD 30 PENFILL (DUAL ACTING HUMAN INSULIN) FROM AN UNKNOWN DATE TOGETHER WITH NOVOPEN 3 (INSULIN DELIVERY DEVICE), NOVOPEN 3 PENMATE (INSULIN DELIVERY DEVICE) AND NOVOFINE 31G (NEEDLE) FOR INSULIN-DEPENDENT DIABETES MELLITUS AND DEVICE THERAPY. IN 2008, THE PATIENT WAS ADMITTED TO THE EMERGENCY UNIT WITH DIABETIC KETOACIDOSIS AND DISCHARGED ON TWO DAYS LATER. THE PATIENT WAS RE-ADMITTED ON THE NEXT DAY AND DISCHARGED. THEN RE-ADMITTED AGAIN ON THE FOLLOWING DAY AND FINALLY DISCHARGED ON TWO DAYS LATER. DURING THE HOSPITALISATION, BLOOD TESTS, SCANS AND X-RAYS WERE PERFORMED. ALSO THE NOVOPEN 3 WAS TESTED AND WAS FOUND TO BE FAULTY. THE PEN WAS NOT EXPELLING INSULIN ALTHOUGH THE INSULIN DOSAGE WAS DIALLED UP ON THE PEN AND ONCE THE NEEDLE WAS INSERTED INTO THE STOMACH, THE DIAL WOULD GO TO ZERO BUT NO INSULIN WAS EXPELLED. THE OVERALL OUTCOME IS REPORTED AS "NOT REPORTED". REPORTER'S CAUSALITY: UNKNOWN. NOVO NORDISK CAUSALITY: REPORTABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NOVOFINE 31G NEEDLE FMI NOVO NORDISK A/S, MEDICAL SYSTEMS NA NA

Patients

Seq Age Sex Outcome Treatment
1 UNK Hospitalization