FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 1881302 · Received October 18, 2010

Report

Report Number
2531779-2010-01724
Event Type
Malfunction
Date Received
October 18, 2010
Date of Event
September 18, 2010
Report Date
September 18, 2010
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP HAS BEEN RETURNED TO ANIMAS FOR EVALUATION. EVALUATION REVEALED THAT THE PUMP WAS INTERMITTENTLY RESPONDING TO UP ARROW BUTTON PRESSES. THE KEYPAD WAS ALSO FOUND TO BE TORN NEAR THE UP ARROW BUTTON. ALSO, THE UP ARROW BUTTON CONTACT WAS FOUND TO BE INVERTED.

Description of Event or Problem · 1

THE PT CONTACTED ANIMAS ALLEGING THAT THE PUMP WAS NOT RESPONDING TO UP ARROW BUTTON PRESSES. THE PT CLAIMED THAT THE UP ARROW BUTTON WAS STUCK AND NOT SPRINGING BACK. HE ALSO CLAIMED THAT IT WOULD TAKE SEVERAL ATTEMPTS TO STOP PROGRAMMING. THE PT DENIED THAT THE DEVICE WAS EXPOSED TO WATER OR SUFFERED PHYSICAL DAMAGE.

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 19 YR