FDA Adverse Event
Malfunction
Summary report: N
AUTOSOFT 30
MDR report key: 19429857
·
Received May 30, 2024
Report
- Report Number
- 3003442380-2024-04850
- Event Type
- Malfunction
- Date Received
- May 30, 2024
- Date of Event
- April 10, 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 1875084- MDR 3003442380-2024-4850- DEVICE 2 OF 3.
Description of Event or Problem · 0
UNOMEDICAL REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES. IT WAS REPORTED THAT PATIENT FACED INFUSION SET CANNULA KINKED ON (B)(6) 2024 AFTER 3 HOURS OF INSERTION. INSERTION SITE WAS ABDOMEN. THE GLUCOSE LEVEL WAS OVER 280 MG/DL. 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 |
|---|---|---|---|---|---|---|---|
| 1276090 | AUTOSOFT 30 | INSET 30 2-PACK 60/13 GREY TCAP | FPA | UNOMEDICAL A/S | 1000283 | 6004065 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 30 YR | Female |