FDA Adverse Event Malfunction Summary report: N

AUTOSOFT XC

MDR report key: 19490760 · Received June 7, 2024

Report

Report Number
3003442380-2024-07045
Event Type
Malfunction
Date Received
June 7, 2024
Date of Event
March 30, 2024
Report Date
June 7, 2024
Manufacturer
UNOMEDICAL A/S
Product Code
FPA
UDI-DI
05705244016620
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 1882069 - MDR 3003442380-2024-07045 - DEVICE 2 OF 10. E1: PATIENT CITY: (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 TEN INFUSION SET CANNULA BENT EVENTS OVER THE PAST 5-6 WEEKS. ALL THE EVENTS OCCURRED AFTER 3 HOURS OF INSERTION AND THE INFUSION SET WAS IN USE FOR 3 TO MORE THAN 3 HOURS. THE INSERTION SITE WAS AT ABDOMEN. THE BLOOD GLUCOSE LEVEL AT THE TIME OF ALL EVENTS WAS 210 MG/DL TO 280 MG/DL AND PATIENT RESOLVED IT 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
998711 AUTOSOFT XC UNO INSET I 60/6 GREY TCAP 10PK INT FPA UNOMEDICAL A/S 1001680 6001898 05705244016620

Patients

Seq Age Sex Outcome Treatment
1 55 YR Female