FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 1911917 · Received November 24, 2010

Report

Report Number
2531779-2010-02534
Event Type
Malfunction
Date Received
November 24, 2010
Date of Event
October 27, 2010
Report Date
October 27, 2010
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP WAS RETURNED TO ANIMAS AND THE EVALUATION REVEALED THAT THE KEYPAD APPEARED TO BE INTACT WITH NO LIFTING OR PEELING. THE "UP" "DOWN" AND "OK" KEYPAD BUTTONS WERE INTERMITTENTLY RESPONDING. THE KEYPAD WAS REMOVED AND THE "UP" "DOWN" AND "OK" KEY CONTACTS BECAME INVERTED WHEN PRESSED 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" AND "DOWN" ARROW BUTTONS WERE INTERMITTENTLY RESPONDING ON THE KEYPAD. THE "OK" BUTTON DID CLICK AND SPRING BACK NORMALLY. THE REPORTER DENIES DAMAGE TO THE KEYPAD OR EXPOSURE 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 51 YR