FDA Adverse Event Injury Summary report: N

ANIMAS INSULIN INFUSION PUMP

MDR report key: 1041170 · Received May 12, 2008

Report

Report Number
2531779-2008-00251
Event Type
Injury
Date Received
May 12, 2008
Date of Event
April 9, 2008
Report Date
April 9, 2008
Manufacturer
ANIMAS CORP.
Product Code
LZG
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP WAS RETURNED TO ANIMAS FOR EVALUATION. UPON RECEIPT AT ANIMAS, THE PUMP WAS FOUND TO HAVE A DAMAGED FORCE SENSOR WHICH RENDERED IT INOPERABLE AS IT COULD NO LONGER BE PRIMED. THE PUMP HISTORY INDICATED THAT THE PUMP WAS IN USE ON THE DATE OF THE HOSPITALIZATION, AND INSULIN DELIVERY WAS CONSISTENT WITH THE PATIENT'S PROGRAMMED DOSAGES.

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