FDA Adverse Event
Malfunction
Summary report: N
ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM
MDR report key: 1881303
·
Received October 18, 2010
Report
- Report Number
- 2531779-2010-01726
- 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
- AR, 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 KEYPAD BUTTON PRESSES. THE KEYPAD WAS REMOVED AND ADHESIVE/CONTAMINATION WAS OBSERVED UNDER THE BUTTON CONTACTS.
Description of Event or Problem · 1
THE REPORTER CONTACTED ANIMAS ON BEHALF OF THE PT (HER DAUGHTER) ALLEGING THAT THE PUMP WAS INTERMITTENTLY NOT RESPONDING TO DOWN ARROW BUTTON PRESSES. THE REPORTER ALSO CLAIMED THAT THE DOWN BUTTON WAS STICKING. THE REPORTER DENIED THAT THE KEYPAD WAS PEELING OR TORN.
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 | 13 YR |