FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 1901603 · Received November 10, 2010

Report

Report Number
2531779-2010-02206
Event Type
Malfunction
Date Received
November 10, 2010
Date of Event
October 11, 2010
Report Date
October 11, 2010
Manufacturer
ANIMAS CORP.
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 AND THE EVAL REVEALED THAT THE KEYPAD APPEARED TO BE INTACT WITH NO LIFTING OR PEELING. ALL KEYPAD BUTTONS WERE INTERMITTENTLY RESPONDING TO USER INPUTS. THE KEYPAD WAS REMOVED AND ALL KEY CONTACTS WERE OBSERVED TO BE INVERTED AND DID NOT ALWAYS SPRING BACK. THERE WAS ALSO EVIDENCE OF KEYPAD ADHESIVE FOUND UNDER ALL KEY CONTACTS.

Description of Event or Problem · 1

THE PT REPORTED THAT THE UP ARROW BUTTON WAS NOT RESPONDING ON THE KEYPAD. THE REPORTER DENIES DAMAGE TO THE KEYPAD AND THE BUTTONS CLICK AND SPRING BACK.

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 27 YR