FDA Adverse Event Injury Summary report: N

ANIMAS INSULIN INFUSION PUMP

MDR report key: 1023276 · Received April 1, 2008

Report

Report Number
2531779-2008-00179
Event Type
Injury
Date Received
April 1, 2008
Date of Event
February 19, 2008
Report Date
February 29, 2008
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE CARTRIDGE HAS NOT BEEN RETURNED TO ANIMAS FOR EVALUATION. ANIMAS IS CURRENTLY CONDUCTING AN EVALUATION OF A CARTRIDGE FROM THIS MANUFACTURING LOT. THIS EVALUATION HAS NOT YET BEEN COMPLETED. NO CONCLUSIONS CAN BE MADE AT THIS TIME.

Description of Event or Problem · 1

THE PATIENT WAS HOSPITALIZED FOR ELEVATED BLOOD GLUCOSE LEVELS AND DKA. THE PATIENT REPORTED THAT THE CARTRIDGE COMPARTMENT EXHIBITED MOISTURE. THE PATIENT ALSO REPORTED THAT NO INSULIN BOLUSES WERE ADMINISTERED FOR 24 HOURS PRIOR TO THE HOSPITALIZATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ANIMAS INSULIN INFUSION PUMP INSULIN INFUSION PUMP LZG ANIMAS CORPORATION IR 1200/1250/2020 B201161

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization