FDA Adverse Event Injury Summary report: N

ANIMAS INSULIN INFUSION PUMP

MDR report key: 1031261 · Received April 18, 2008

Report

Report Number
2531779-2008-00215
Event Type
Injury
Date Received
April 18, 2008
Date of Event
March 14, 2008
Report Date
March 17, 2008
Manufacturer
ANIMAS CORP.
Product Code
LZG
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
VT, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP WAS RETURNED TO ANIMAS FOR EVALUATION. EVALUATION REVEALED DAMAGE TO THE SEAL IN THE PUMP HOUSING BUT DEMONSTRATED THAT PUMP INSULIN DELIVERY WAS OPERATING WITHIN REQUIRED SPECIFICATIONS AND DELIVERY ACCURACY.

Description of Event or Problem · 1

THE PATIENT WAS HOSPITALIZED FOR ELEVATED BLOOD GLUCOSE LEVELS AND DKA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ANIMAS INSULIN INFUSION PUMP INSULIN INFUSION PUMP LZG ANIMAS CORP. IR 1200

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization