BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ANIMAS INSULIN INFUSION PUMP

    MDR report key: 1923922 · Received December 13, 2010

    Report

    Report Number
    2531779-2010-02835
    Event Type
    Malfunction
    Date Received
    December 13, 2010
    Report Date
    September 30, 2010
    Manufacturer
    ANIMAS CORP.
    Product Code
    LZG
    PMA / PMN Number
    K042873
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    THE PUMP WAS RETURNED TO ANIMAS FOR EVAL. THE RESULTS OF THE INVESTIGATION WERE AS NOTED: NO VISUAL DAMAGE TO THE KEYPAD OBSERVED, THE UP, DOWN AND OK KEYPAD BUTTONS WERE STICKING AND INTERMITTENTLY UNRESPONSIVE TO USER INPUT DURING TESTING, AND CONTAMINATION WAS OBSERVED UNDER THE UP, DOWN AND OK KEY CONTACTS.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE KEYPAD BUTTON PRESSES DID NOT ACTIVATE DESIRED PUMP FUNCTIONS. THE UP AND DOWN ARROW KEYPAD BUTTONS SLOW TO RESPOND. IT WAS REPORTED THAT THE UP AND DOWN KEYPAD BUTTONS FEEL MORE DEPRESSED THAN USUAL. KEYPAD IS INTACT. THERE WAS NO ADVERSE EVENT ASSOCIATED WITH THIS COMPLAINT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ANIMAS INSULIN INFUSION PUMP INSULIN INFUSION PUMP LZG ANIMAS CORP. ANIMAS 2020 NA

    Patients

    Seq Age Sex Outcome Treatment
    1