FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 1881514 · Received October 19, 2010

Report

Report Number
2531779-2010-01750
Event Type
Malfunction
Date Received
October 19, 2010
Report Date
September 20, 2010
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP HAS NOT BEEN RETURNED TO ANIMAS FOR EVAL. IF THE DEVICE IS RETURNED, AN EVAL SHALL BE COMPLETED AND A SUPPLEMENTAL REPORT WILL BE FILLED. NO CONCLUSIONS CAN BE DRAWN AT THIS TIME.

Description of Event or Problem · 1

ACCORDING TO THE PT'S FATHER, THE PUMP IS NOT RESPONDING WHEN THE BUTTONS ARE PRESSED AND THE BUTTONS ARE STICKING. THE PT'S FATHER CLAIMS THAT THE KEYPAD IS INTACT AND THAT THE PUMP HAS NOT BEEN EXPOSED TO MOISTURE.

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