FDA Adverse Event Malfunction Summary report: N

AUTOSOFT XC

MDR report key: 19495719 · Received June 9, 2024

Report

Report Number
3003442380-2024-07422
Event Type
Malfunction
Date Received
June 9, 2024
Date of Event
April 26, 2024
Report Date
June 9, 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 1883780 - MDR 3003442380-2024-07422- DEVICE 2 OF 5. (B)(6).

Description of Event or Problem · 0

UNOMEDICAL REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES. IT WAS REPORTED THAT THE PATIENT ENCOUNTERED FIVE INFUSION SET CANNULAS WERE KINKED WITHIN 3 OR MORE HOURS AFTER INSERTION WHICH LED TO HIGH BLOOD GLUCOSE LEVEL OF 300-458MG/DL. THE INSERTION SITE WAS AT ABDOMEN. THE PATIENT CONFIRMED THAT THE INTRODUCER NEEDLE WAS AHEAD OF THE CANNULA PRIOR TO INSERTION AND REGULARLY ROTATED THE SITE LOCATION. THE ISSUE GOT RESOLVED BY CHANGING SUPPLIES AS NECESSARY AND RESUMED INSULIN THERAPY. THE INFUSION SET IN USE FOR 10 MIN - 3 DAYS. 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
2326109 AUTOSOFT XC UNO INSET I 60/6 GREY TCAP 10PK INT FPA UNOMEDICAL A/S 1001680 6003530 05705244016620

Patients

Seq Age Sex Outcome Treatment
1 46 YR Female