FDA Adverse Event
Malfunction
Summary report: N
AUTOSOFT 90
MDR report key: 19674683
·
Received July 4, 2024
Report
- Report Number
- 3003442380-2024-11757
- Event Type
- Malfunction
- Date Received
- July 4, 2024
- Date of Event
- May 30, 2024
- Report Date
- October 27, 2025
- Manufacturer
- UNOMEDICAL A/S
- Product Code
- FPA
- UDI-DI
- 05705244018181
- 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 1901830- MDR 3003442380-2024-11757- DEVICE 5 OF 6.
Description of Event or Problem · 0
UNOMEDICAL REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED KINGDOM. IT WAS REPORTED THAT THE PATIENT'S INFUSION SET WAS LEAKING AT SITE ON (B)(6) 2024. THE BLOOD GLUCOSE LEVEL OF THE PATIENT WAS 12.2MMOL. MOREOVER, THE ISSUE OCCURRED WITH SIX SIMILAR TYPES OF INFUSION SETS USED FOR 24 HOURS. NO FURTHER INFORMATION AVAILABLE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1270513 | AUTOSOFT 90 | UNO INSET II 60/9 GREY TCAP 10PK INT | FPA | UNOMEDICAL A/S | 1002819 | 6002617 | 05705244018181 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |