FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 1893665 · Received November 2, 2010

Report

Report Number
2531779-2010-02040
Event Type
Malfunction
Date Received
November 2, 2010
Date of Event
October 1, 2010
Report Date
October 1, 2010
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UT, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP WAS RETURNED TO ANIMAS FOR EVALUATION. THE KEYPAD WAS OBSERVED TO BE SWOLLEN. THE BUTTONS WERE FOUND TO BE INTERMITTENTLY RESPONDING. THE KEYPAD WAS REMOVED AND THE 'UP' AND 'DOWN' BUTTON CONTACTS WERE FOUND TO BE MISALIGNED. ADHESIVE WAS OBSERVED UNDER THE BUTTON CONTACTS.

Description of Event or Problem · 1

THE PATIENT REPORTED THAT THE BUTTONS HAVE BEEN INTERMITTENTLY UNRESPONSIVE FOR PAST FEW WEEKS. REPORTS HAS TO PRESS BUTTON MULTIPLE TIMES TO GET RESPONSIVE AT TIMES. PUMP NOT 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 30 YR