FDA Adverse Event Malfunction Summary report: N

AUTOSOFT 90

MDR report key: 19476310 · Received June 6, 2024

Report

Report Number
3003442380-2024-06305
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 2 OF 2.

Description of Event or Problem · 0

UNOMEDICAL REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES, IT WAS REPORTED THAT ON 21-APR-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
2055521 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