FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 1881326 · Received October 18, 2010

Report

Report Number
2531779-2010-01728
Event Type
Malfunction
Date Received
October 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
CA, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP WAS RETURNED TO ANIMAS FOR EVALUATION. THE RESULTS OF THE INVESTIGATION WERE AS NOTED: THE KEYPAD WAS TORN NEAR THE OK AND DOWN ARROW BUTTONS, THE PUMP WAS UNRESPONSIVE TO THE DOWN ARROW AND OK BUTTONS, AND THE DOWN ARROW AND OK BUTTONS WERE INVERTED.

Description of Event or Problem · 1

THE PUMP IS REPORTEDLY INTERMITTENTLY RESPONDING WHEN THE BUTTONS ARE PRESSED, THE BUTTONS ARE STICKING, AND THE KEYPAD IS 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