FDA Adverse Event Malfunction Summary report: N

AUTOSOFT 90

MDR report key: 19432395 · Received May 30, 2024

Report

Report Number
3003442380-2024-04476
Event Type
Malfunction
Date Received
May 30, 2024
Date of Event
April 26, 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 1874986 - MDR 3003442380-2024-04476 - DEVICE 1 OF 3.

Description of Event or Problem · 0

UNOMEDICAL REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES. ON (B)(6) 2024, IT WAS REPORTED BY THE PATIENT THAT THREE INFUSION SET WAS BENT DUE TO WHICH HYPERGLYCEMIA OCCURS AFTER 3 HOURS OF INSERTION. BLOOD GLUCOSE LEVEL WAS 395 MG/DL. EVENT OCCURRED ON (B)(6) 2024. INFUSION SET WAS PLACED IN ABDOMEN. HIGH BLOOD GLUCOSE LEVEL WAS TREATED BY THE CORRECTION INJECTION VIA MDI AND CHANGED INFUSION SET. 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
332141 AUTOSOFT 90 UNO INSET II 60/6 GREY TCAP 10PK INT FPA UNOMEDICAL A/S UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 8 YR Female