FDA Adverse Event Injury Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 1231623 · Received November 13, 2008

Report

Report Number
2531779-2008-00787
Event Type
Injury
Date Received
November 13, 2008
Date of Event
October 16, 2008
Report Date
October 17, 2008
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
PMA / PMN Number
K080639
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
LA, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP WAS RETURNED TO ANIMAS FOR EVALUATION. EVALUATION DEMONSTRATED THAT THE PUMP WAS OPERATING WITHIN REQUIRED SPECIFICATION AND DELIVERY ACCURACY.

Description of Event or Problem · 1

PT'S FATHER REPORTS HOSPITALIZATION DUE TO ELEVATED BLOOD GLUCOSE LEVELS AND DKA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM INSULIN INFUSION PUMP LZG ANIMAS CORPORATION ONE TOUCH PING

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization