FDA Adverse Event
Malfunction
Summary report: N
TRUSTEEL
MDR report key: 19421708
·
Received May 29, 2024
Report
- Report Number
- 3003442380-2024-04285
- Event Type
- Malfunction
- Date Received
- May 29, 2024
- Date of Event
- February 1, 2024
- Report Date
- May 29, 2024
- Manufacturer
- UNOMEDICAL A/S
- Product Code
- FPA
- PMA / PMN Number
- K041545
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 0
MDR 3003442380-2024-04285 - DEVICE 6 OF 10.
Description of Event or Problem · 0
UNOMEDICAL REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES. IT WAS REPORTED THAT TEN INFUSION SETS CANNULA WERE BENT. THE EVENT DATES WERE BETWEEN (B)(6) 2024. PATIENT'S BLOOD GLUCOSE LEVEL WAS BETWEEN 200-401 MG/DL. WITHIN 3 HOURS OF INSERTION CUSTOMER NOTICED SYMPTOMS. CUSTOMER REPLACED INFUSION SET AND RESUMED INSULIN DELIVERIES SUCCESSFULLY. UNOMEDICAL DO NOT SEE BENT/KINKING AS BEING RELATED TO HUMAN FACTORS, BUT RATHER AS A TRAINING ISSUE INCLUDING CORRECT CHOICES OF INSERTION SITES AND INFUSION SETS AND CANNULA LENGTH. FURTHERMORE, THE SOFT CANNULA IS A FLEXIBLE MATERIAL THAT DURING USE AND UPON REMOVAL CAN BEND SLIGHTLY. NO FURTHER INFORMATION AVAILABLE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1286282 | TRUSTEEL | UNO CONTACT DETACH G29 60/6TCAP 10PK INT | FPA | UNOMEDICAL A/S | UNKNOWN |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 9 YR | Male |