FDA Adverse Event
Malfunction
Summary report: N
TRUSTEEL
MDR report key: 19491889
·
Received June 7, 2024
Report
- Report Number
- 3003442380-2024-06974
- Event Type
- Malfunction
- Date Received
- June 7, 2024
- Date of Event
- February 1, 2024
- Report Date
- June 7, 2024
- Manufacturer
- UNOMEDICAL A/S
- Product Code
- FPA
- UDI-DI
- 05705244018426
- PMA / PMN Number
- K041545
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 0
INITIAL AND FINAL MDR 1881884 - DEVICE 4 OF 5. PATIENT COUNTRY: UNITED STATES.
Description of Event or Problem · 0
UNOMEDICAL REFERENCE NUMBER (B)(4).EVENT OCCURRED IN THE UNITED STATES.IT WAS REPORTED THAT PATIENT FACED AN ISSUE WITH FIVE INFUSIONS SETS WERE FELL OFF DURING USE ON (B)(6) 2024. THE INFUSION SET WAS IN USE FOR ONE DAY. THE PATIENT REPLACED INFUSION SET AND RESUMED INSULIN DELIVERIES SUCCESSFULLY.NO FURTHER INFORMATION AVAILABLE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2318761 | TRUSTEEL | UNO CONTACT DETACH G29 60/6TCAP 10PK INT | FPA | UNOMEDICAL A/S | 1002833 | UNKNOWN | 05705244018426 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 9 YR | Male |