FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 1870443 · Received October 6, 2010

Report

Report Number
2531779-2010-01468
Event Type
Malfunction
Date Received
October 6, 2010
Report Date
September 6, 2010
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP HAS NOT BEEN RETURNED TO ANIMAS FOR EVAL. IF THE DEVICE IS RETURNED, AN EVAL SHALL BE COMPLETED AND A SUPPLEMENTAL REPORT WILL BE FILED. NO CONCLUSIONS CAN BE DRAWN AT THIS TIME.

Description of Event or Problem · 1

THE PT NOTICED THAT THE "OK" BUTTON WAS DIFFICULT TO PUSH SEVERAL WEEKS AGO WHEREAS THE OTHER BUTTONS WORK W/O ANY DIFFICULTIES. THE PT REPORTED NO CUTS IN THE KEYPAD, THAT IT FELT LIKE SOMETHING WAS LOOSE UNDER THE KEYPAD, THERE WAS NO WATER EXPOSURE, AND NO CLEANING PRODUCTS WERE USED ON THE PUMP.

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 NA

Patients

Seq Age Sex Outcome Treatment
1