BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ANIMAS INSULIN INFUSION PUMP

    MDR report key: 1934986 · Received December 3, 2010

    Report

    Report Number
    2531779-2010-02719
    Event Type
    Malfunction
    Date Received
    December 3, 2010
    Report Date
    November 3, 2010
    Manufacturer
    ANIMAS CORP.
    Product Code
    LZG
    PMA / PMN Number
    K042873
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    THE PUMP WAS RETURNED TO ANIMAS FOR EVAL. THE RESULTS OF THE INVESTIGATION WERE AS NOTED: THE PUMP WAS RETURNED WITH THE KEYPAD LIFTING UP BELOW THE "OK" KEYPAD BUTTON. THE "UP/DOWN/OK/CONTRAST" KEYPAD BUTTONS ARE INTERMITTENTLY RESPONDING AND REQUIRE EXCESSIVE FORCE TO ACTIVATE DURING TESTING. THE KEYPAD WAS REMOVED FOR FURTHER INVESTIGATION. DURING A VISUAL INSPECTION, THE "UP/DOWN" KEY CONTACTS ARE MISALIGNED, AND THE "UP/DOWN/OK/CONTRAST" KEY CONTACTS ARE INVERTED AND DO NOT ALWAYS SPRING BACK. THERE WAS EVIDENCE OF KEYPAD ADHESIVE FOUND UNDER ALL KEY CONTACTS.

    Description of Event or Problem · 1

    THE LAY-USER/PT ALLEGED THAT THE BUTTON ON THE KEYPAD DO NOT RESPOND. THERE WAS PRODUCT MISUSE. THE KEYPAD DID NOT APPEAR TO BE PEELED OR TORN. FURTHERMORE, 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