FDA Adverse Event Malfunction Summary report: N

AUTOSOFT 90

MDR report key: 19477995 · Received June 6, 2024

Report

Report Number
3003442380-2024-06700
Event Type
Malfunction
Date Received
June 6, 2024
Date of Event
April 29, 2024
Report Date
June 6, 2024
Manufacturer
UNOMEDICAL A/S
Product Code
FPA
UDI-DI
05705244018334
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 1880593. 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 PATIENT FACED 2 INFUSION SET CANNULA KINKED EVENTS ON (B)(6) 2024 AFTER 3 OR MORE HOURS OF INERSTION. THE INSERTION SITE WAS AT ABDOMEN. CUSTOMER REGULARLY ROTATE SITE LOCATION. INFUSION SET HAS BEEN USED FOR A FEW HOURS. THE BLOOD GLUCOSE LEVEL WAS OVER 350 MG/DL. THE CUSTOMER REPLACED INFUSION SET AND RESUMED INSULIN DELIVERIES 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
12350 AUTOSOFT 90 UNO INSET II 60/9 BLUE TCAP 10PK INT FPA UNOMEDICAL A/S 1002824 5381317 05705244018334

Patients

Seq Age Sex Outcome Treatment
1 61 YR Male