FDA Adverse Event Injury Summary report: N

ANIMAS INSULIN INFUSION PUMP

MDR report key: 1171123 · Received September 22, 2008

Report

Report Number
2531779-2008-00615
Event Type
Injury
Date Received
September 22, 2008
Date of Event
August 21, 2008
Report Date
August 21, 2008
Manufacturer
ANIMAS CORP.
Product Code
LZG
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PUMP HAS NOT BEEN RETURNED TO ANIMAS FOR EVAL. ANIMAS HAS CONDUCTED A REVIEW OF THE DEVICE HISTORY RECORD FOR THIS PUMP AND IT WAS OPERATING WITHIN REQUIRED SPECS AT THE TIME OF RELEASE. THE PT'S BASAL INSULIN DOSAGE HAS BEEN REDUCED AND THE PT HAS CONTINUED TO USE THE PUMP WITH NO REPORTED SUBSEQUENT EVENTS. IF THE DEVICE IS RETURNED, AN EVAL 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 PT WAS HOSPITALIZED FOR HYPOGLYCEMIA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ANIMAS INSULIN INFUSION PUMP INSULIN INFUSION PUMP LZG ANIMAS CORP. IR 1250

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization