FDA Adverse Event Malfunction Summary report: N

AUTOSOFT 30

MDR report key: 19474468 · Received June 6, 2024

Report

Report Number
3003442380-2024-06388
Event Type
Malfunction
Date Received
June 6, 2024
Date of Event
April 16, 2024
Report Date
June 6, 2024
Manufacturer
UNOMEDICAL A/S
Product Code
FPA
UDI-DI
05705244018365
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 1880687 - MDR 3003442380-2024-06388 - DEVICE 3 OF 17. E1: (B)(6).

Description of Event or Problem · 0

UNOMEDICAL REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES. IT WAS REPORTED THAT PATIENT FACED SEVENTEEN INFUSION SET CANNULA BENT EVENTS, FIRST ON (B)(6) 2024 AND OTHER WITHIN LAST 2 WEEKS. ALL THE EVENTS OCCURRED WITHIN 3 HOURS OF INSERTION AND THE INSERTION SITE WAS AT ABDOMEN. THE BLOOD GLUCOSE LEVEL AT THE TIME OF FIRST EVENT WAS NORMAL AND OTHER EVENTS WAS 485MG/DL. THE PATIENT RESOLVE ALL THE EVENTS BY CHANGING SOFT CANNULA INFUSION SET 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 AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1841183 AUTOSOFT 30 UNO INSET 30 60/13 GREY TCAP 10PK INT FPA UNOMEDICAL A/S 1002825 6004147 05705244018365

Patients

Seq Age Sex Outcome Treatment
1 56 YR Male