FDA Adverse Event Malfunction Summary report: N

AUTOSOFT 90

MDR report key: 19489345 · Received June 7, 2024

Report

Report Number
3003442380-2024-07121
Event Type
Malfunction
Date Received
June 7, 2024
Date of Event
April 24, 2023
Report Date
June 7, 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 1882090 - MDR 3003442380-2024-07121 - DEVICE 4 OF 7.

Description of Event or Problem · 0

UNOMEDICAL REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES. IT WAS REPORTED THAT THE PATIENT FACED SIMILAR EVENTS OF BENT CANNULA WITH SEVEN INFUSION SETS. THE SYMPTOMS WERE NOTICED WITHIN 3 HOURS OF INSERTION. THE SITE OF INSERTION WAS ABDOMEN AND WAS ROTATED REGULARLY. PATIENT'S BLOOD GLUCOSE AT THE TIME OF EVENT WAS 350MG/DL. THEREFORE, PATIENT 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
2095696 AUTOSOFT 90 UNO INSET II 60/9 BLUE TCAP 10PK INT FPA UNOMEDICAL A/S 1002824 6002402 05705244018334

Patients

Seq Age Sex Outcome Treatment
1 64 YR Male