FDA Adverse Event Injury Summary report: N

AUTOSOFT XC

MDR report key: 19518710 · Received June 12, 2024

Report

Report Number
3003442380-2024-07768
Event Type
Injury
Date Received
June 12, 2024
Date of Event
February 6, 2024
Report Date
June 12, 2024
Manufacturer
UNOMEDICAL A/S
Product Code
FPA
UDI-DI
05705244016958
PMA / PMN Number
K032854
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

INITIAL MDR 1885139 - DEVICE 4 OF 4.

Description of Event or Problem · 0

UNOMEDICAL REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES. IT WAS REPORTED THAT PATIENT FACED FOUR INFUSION SET CANNULA WAS BENT EVENT ON (B)(6) 2024. THE BLOOD GLUCOSE LEVEL WAS DISPLAYED HIGH AT THE TIME OF EVENT AND WAS MANAGED BY MULTIPLE DAILY INJECTIONS (MDI). THE EVENT OCCURED 3 OR MORE HOURS AFTER INSERTION. THE SITE OF INSERTION WAS AT ABDOMEN. THE INFUSION SET WAS IN USE UP TO A DAY. 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
394482 AUTOSOFT XC UNO INSET I 110/9 GREY TCAP 10PK INT FPA UNOMEDICAL A/S 1001729 UNKNOWN 05705244016958

Patients

Seq Age Sex Outcome Treatment
1 81 YR Male