FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 1883863 · Received October 23, 2010

Report

Report Number
2531779-2010-01875
Event Type
Malfunction
Date Received
October 23, 2010
Date of Event
September 24, 2010
Report Date
September 24, 2010
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K080639
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP HAS BEEN RETURNED TO ANIMAS FOR EVAL. EVAL REVEALED THAT THE PUMP WAS INTERMITTENTLY UNRESPONSIVE TO UP AND DOWN ARROW BUTTON PRESSES. THE OK BUTTON WAS ALSO OBSERVED TO BE HYPERSENSITIVE AND WOULD NOT CLICK OR SPRING BACK. ADHESIVE/CONTAMINATION WAS OBSERVED UNDER THE UP, DOWN AND OK BUTTON CONTACT. THE OK BUTTON CONTACT WAS FOUND TO BE INVERTED.

Description of Event or Problem · 1

THE PT CONTACTED ANIMAS ALLEGING THAT THE PUMP WAS INTERMITTENTLY UNRESPONSIVE TO OK AND DOWN ARROW BUTTON PRESSES. THE PT DENIED THAT THE KEYPAD WAS PEELING.

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 32 YR