FDA Adverse Event Malfunction Summary report: N

EASYTOUCH

MDR report key: 17165939 · Received June 20, 2023

Report

Report Number
3005798905-2023-03121
Event Type
Malfunction
Date Received
June 20, 2023
Date of Event
June 8, 2023
Report Date
June 20, 2023
Manufacturer
FEEL TECH BIO CO., LTD.
Product Code
FMI
PMA / PMN Number
K112789
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THE AFFECTED DEVICE WAS RETURNED TO THE CMO ON (B)(6) 2023 TESTING, DURING DEVICE TESTING THE CMO FOUND NO IRREGULARITIES AND THE DEVICE WAS FOUND TO BE IN GOOD WORKING CONDITION. COMPLAINT CLOSED PER CMO BASED ON RESULTS FROM TESTING.

Additional Manufacturer Narrative · 0

INITIAL TREND ANALYSIS FOR LOT 568718P WAS CONDUCTED, NO MALFUNCTIONS WERE FOUND. THIS IS THE ONLY COMPLAINT FOR LOT 568718P. FURTHER INVESTIGATION WILL BE CONDUCTED TO DETERMINE THE ROOT CAUSE OF COMPLAINT.

Description of Event or Problem · 0

END USER REPORTS THAT EASYTOUCH PEN NEEDLES ITEM NUMBER 831041 LOT 568718P ARE DULL.

Description of Event or Problem · 0

END USER REPORTS THAT EASYTOUCH PEN NEEDLES ITEM NUMBER 831041 LOT 568718P ARE DULL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
526566 EASYTOUCH PEN NEEDLE FMI FEEL TECH BIO CO., LTD. 568718P

Patients

Seq Age Sex Outcome Treatment
1 Unknown