FDA Adverse Event Malfunction Summary report: N

AUTOSOFT XC

MDR report key: 19429124 · Received May 30, 2024

Report

Report Number
3003442380-2024-04761
Event Type
Malfunction
Date Received
May 30, 2024
Date of Event
April 6, 2024
Report Date
May 30, 2024
Manufacturer
UNOMEDICAL A/S
Product Code
FPA
PMA / PMN Number
K032854
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

INITIAL AND FINAL MDR 1874900 - DEVICE 6 OF 9.

Description of Event or Problem · 0

UNOMEDICAL REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES. ON 06-APR-2024, IT WAS REPORTED THAT PATIENT FACED NINE INFUSION SET CANNULA BENT EVENTS. THE EVENTS OCCURED AFTER 3 OR MORE HOURS AFTER INSERTION. THE INFUSION SETS HAD BEEN USED FOR COUPLE OF HOURS.THE INSERTION SITE WAS AT THE THIGH AND HIP WITH FATTY AREA. THE BLOOD GLUCOSE LEVEL WAS UNKNOWN AT THE TIME OF EVENT. THE PATIENT REPLACED INFUSION SETS AND RESUMED INSULIN 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 WAS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1128951 AUTOSOFT XC UNO INSET I 60/6 GREY TCAP 10PK INT FPA UNOMEDICAL A/S 1001680 6002489

Patients

Seq Age Sex Outcome Treatment
1 57 YR Female