FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 1901573 · Received November 10, 2010

Report

Report Number
2531779-2010-02204
Event Type
Malfunction
Date Received
November 10, 2010
Date of Event
October 10, 2010
Report Date
October 10, 2010
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP HAS BEEN RETURNED TO ANIMAS FOR EVAL. EVAL REVEALED THAT THE PUMP WAS NOT RESPONDING TO UP, DOWN, AND OK KEYPAD BUTTON PRESSES. THE KEYPAD WAS REMOVED AND ADHESIVE/CONTAMINATION WAS OBSERVED UNDER THE BUTTON CONTACTS. IN ADDITION, THE BUTTON CONTACTS WERE OBSERVED TO BE INVERTED AND WERE NOT SPRINGING BACK. ALSO, THE UP AND DOWN BUTTON CONTACTS WERE MISALIGNED. THE KEYPAD ALSO APPEARED TO BE INTACT WITH NO LIFTING OR PEELING. MOISTURE WAS OBSERVED THROUGH THE DISPLAY LENS. A LAST TEST REVEALED A KEYPAD LEAK. THERE WAS NO REPORTED PT IMPACT ASSOCIATED WITH THIS COMPLAINT.

Description of Event or Problem · 1

THE PT CONTACTED ANIMAS ALLEGING THAT THE PUMP WAS NOT RESPONDING TO BUTTON PRESSES.

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 57 YR