BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ANIMAS INSULIN INFUSION PUMP

    MDR report key: 1131957 · Received August 21, 2008

    Report

    Report Number
    2531779-2008-00508
    Event Type
    Injury
    Date Received
    August 21, 2008
    Date of Event
    July 20, 2008
    Report Date
    July 20, 2008
    Manufacturer
    ANIMAS CORPORATION
    Product Code
    LZG
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    THE PUMP WAS RETURNED TO ANIMAS FOR EVALUATION. EVALUATION HAS NOT BEEN COMPLETED.

    Description of Event or Problem · 1

    THE PT 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 PIMP LZG ANIMAS CORPORATION IR 1250

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization