FDA Adverse Event
Malfunction
Summary report: N
AUTOSOFT 90
MDR report key: 19476295
·
Received June 6, 2024
Report
- Report Number
- 3003442380-2024-06304
- Event Type
- Malfunction
- Date Received
- June 6, 2024
- Date of Event
- April 21, 2024
- Report Date
- June 6, 2024
- Manufacturer
- UNOMEDICAL A/S
- Product Code
- FPA
- UDI-DI
- 05705244014572
- 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 1880823 - DEVICE 1 OF 2.
Description of Event or Problem · 0
UNOMEDICAL REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES, IT WAS REPORTED THAT ON (B)(6) 2024 THE PATIENT FACED TWO-INFUSION SET CANNULA WAS BENT WITHIN 3 HOURS OF INSERTION. THE SITE OF INSERTION IS ABDOMEN OCCUR ON (B)(6) 2024 & UPPER THIGH ON (B)(6) 2024. 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 |
|---|---|---|---|---|---|---|---|
| 2054517 | AUTOSOFT 90 | INSET II 2-PACK 60/9 GREY TCAP | FPA | UNOMEDICAL A/S | 1000282 | UNKNOWN | 05705244014572 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 68 YR | Female |