FDA Adverse Event Injury Summary report: N

AUTOSOFT XC

MDR report key: 19590732 · Received June 22, 2024

Report

Report Number
3003442380-2024-09368
Event Type
Injury
Date Received
June 22, 2024
Date of Event
May 23, 2024
Report Date
August 16, 2025
Manufacturer
UNOMEDICAL A/S
Product Code
FPA
UDI-DI
05705244016620
PMA / PMN Number
K032854
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

INITIAL AND FINAL MDR 1893416 - MDR 3003442380-2024-09368- DEVICE 1 OF 3.

Description of Event or Problem · 0

UNOMEDICAL REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES. ON (B)(6) 2024, IT WAS REPORTED THAT ON (B)(6) 2024, PATIENT EXPERIENCED INFUSION SET CANNULA WAS KINKED. WITHIN 3 OR MORE HOURS OF ABDOMEN AND THE HIP AREA INSERTION CUSTOMER NOTICED SYMPTOMS. THE BLOOD GLUCOSE LEVEL OF THE PATIENT WAS 600 MG/DL. THEREFORE, THEY TRIED TO TREAT IT WITH CORRECTION BOLUS VIA PUMP AND MULTIPLE DAILY INJECTION. THE MULTIPLE EVENTS OCCURRED, FIRST HAPPENED ON (B)(6) 2024, SECOND ON (B)(6) 2024 AND THIRD ON 06 MAY 2024. ADDITIONALLY, THE PATIENT HAD MODERATE KETONES. ON (B)(6) 2024 PATIENT VISITED EMERGENCY ROOM FOR FEW HOURS AND TREATED WITH INTRAVENOUS (IV) AND FLUIDS OF SALINE AND INSULIN. 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 WAS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1104235 AUTOSOFT XC UNO INSET I 60/6 GREY TCAP 10PK INT FPA UNOMEDICAL A/S 1001680 6000610 05705244016620

Patients

Seq Age Sex Outcome Treatment
1 44 YR Female Required Intervention