BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ANIMAS INSULIN INFUSION PUMP

    MDR report key: 1942412 · Received December 23, 2010

    Report

    Report Number
    2531779-2010-03088
    Event Type
    Malfunction
    Date Received
    December 23, 2010
    Report Date
    November 26, 2010
    Manufacturer
    ANIMAS CORP
    Product Code
    LZG
    PMA / PMN Number
    K042873
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, 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 KEYPAD APPEARS TO BE INTACT NO LIFTING OR PEELING. THE "UP/DOWN/OK/CONTRAST" KEYPAD BUTTONS ARE INTERMITTENTLY RESPONDING TO USER INPUTS DURING TESTING. THE KEYPAD WAS REMOVED FOR FURTHER INVESTIGATION. INSPECTION, THE "UP/DOWN/OK/CONTRAST" KEY CONTACTS ARE MISALIGNED, THE "CONTRAST" KEY CONTACT IS INVERTED, AND THE "UP/DOWN/OK" KEY CONTACTS BECOMES INVERTED WHEN PRESSED AND DO NOT ALWAYS CLICK AND SPRING BACK. THERE WAS EVIDENCE KEYPAD ADHESIVE FOUND UNDER ALL KEY CONTACTS.

    Description of Event or Problem · 1

    THIS COMPLAINT IS BEING REPORTED DUE TO AN ALLEGED KEYPAD MALFUNCTION. THERE WAS NO REPORT OF PRODUCT MISUSE. THE KEYPAD DID NOT APPEAR TO BE PEELED OR TORN. FURTHERMORE, THERE WAS NO ADVERSE EVENT ASSOCIATED WITH THIS COMPLAINT. REPLACEMENT PRODUCTS WERE SENT TO THE PT.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1