FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 1874136 · Received October 15, 2010

Report

Report Number
2531779-2010-01679
Event Type
Malfunction
Date Received
October 15, 2010
Report Date
September 15, 2010
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP HAS BEEN RETURNED TO ANIMAS; HOWEVER, THE INVESTIGATION HAS NOT BEEN COMPLETED. NO CONCLUSIONS CAN BE DRAWN AT THIS TIME. ONCE THE EVAL HAS BEEN COMPLETED A SUPPLEMENTAL REPORT WILL BE FILED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PUMP IS INTERMITTENTLY RESPONDING WHEN THE BUTTONS ARE PRESSED AND THE PUMP IS UNRESPONSIVE TO THE UP ARROW BUTTON. THE PUMP REPORTEDLY HAS NOT BEEN EXPOSED TO WATER.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1