FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 1901619 · Received November 10, 2010

Report

Report Number
2531779-2010-02231
Event Type
Malfunction
Date Received
November 10, 2010
Report Date
October 13, 2010
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP WAS RETURNED TO ANIMAS FOR EVAL. THE RESULTS OF THE INVESTIGATION WERE AS NOTED: THE KEYPAD APPEARED TO BE INTACT (NO LIFTING OR PEELING), THE PUMP WAS INTERMITTENTLY RESPONDING TO KEYPAD BUTTON PRESSES, THE UP ARROW AND CONTRAST KEY CONTACTS WERE MISALIGNED, ALL KEY CONTACTS WERE INVERTED AND DID NOT ALWAYS SPRING BACK, AND THERE WAS EVIDENCE OF ADHESIVE/CONTAMINATION UNDER ALL KEY CONTACTS.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PUMP IS NOT ALWAYS RESPONDING TO THE DOWN ARROW BUTTON. THE PUMP REPORTEDLY HAS NOT BEEN EXPOSED TO WATER AND THE KEYPAD IS INTACT. THERE WAS NO ADVERSE EVENT ASSOCIATED WITH THIS COMPLAINT.

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