FDA Adverse Event Injury Summary report: N

ANIMAS INSULIN INFUSION PUMP

MDR report key: 1160487 · Received September 12, 2008

Report

Report Number
2531779-2008-00581
Event Type
Injury
Date Received
September 12, 2008
Date of Event
August 8, 2008
Report Date
August 12, 2008
Manufacturer
ANIMAS CORP.
Product Code
LZG
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP HAS NOT BEEN RETURNED TO ANIMAS FOR EVALUATION. IF THE DEVICE IS RETURNED, AN EVALUATION SHALL BE COMPLETED AND A SUPPLEMENTAL REPORT WILL BE FILED. 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.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ANIMAS INSULIN INFUSION PUMP INSULIN INFUSION PUMP LZG ANIMAS CORP. IR 1000

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization