BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    AUTOSOFT 90

    MDR report key: 19495177 · Received June 9, 2024

    Report

    Report Number
    3003442380-2024-07347
    Event Type
    Malfunction
    Date Received
    June 9, 2024
    Date of Event
    May 4, 2024
    Report Date
    June 9, 2024
    Manufacturer
    UNOMEDICAL A/S
    Product Code
    FPA
    UDI-DI
    05705244018129
    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 1883876- MDR 3003442380-2024-07347- DEVICE 5 OF 5.

    Description of Event or Problem · 0

    UNOMEDICAL REFERENCE NUMBER (B)(4). EVENT OCCURRED IN SPAIN. IT WAS REPORTED THAT THE PATIENT'S INFUSION SET FELL OFF DURING USE (B)(6) 2024. THE ISSUE OCCURRED WITH FIVE INFUSION SET USED FOR FEW HOURS. NO FURTHER INFORMATION AVAILABLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    2327007 AUTOSOFT 90 UNO INSET II 60/6 GREY TCAP 10PK INT FPA UNOMEDICAL A/S 1002817 5408438 05705244018129

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Female