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