FDA Adverse Event Injury Summary report: N

INFUSION DEVICES - UNKNOWN

MDR report key: 19686044 · Received July 7, 2024

Report

Report Number
3003442380-2024-12711
Event Type
Injury
Date Received
July 7, 2024
Date of Event
June 4, 2024
Report Date
January 26, 2026
Manufacturer
UNOMEDICAL A/S
Product Code
FPA
PMA / PMN Number
UNKNOWN
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

INITIAL AND FINAL MDR 1905812 - MDR 3003442380-2024-12711 - DEVICE 6 OF 11. (B)(6).

Description of Event or Problem · 0

UNOMEDICAL REFERENCE NUMBER (B)(4). EVENT OCCURRED IN AUSTRALIA. ON (B)(6) 2024, IT WAS REPORTED THAT THE PATIENT FACED INFUSION SET CANNULA WAS BENT ON THE INSERTION SITE AT ABDOMEN, WHICH CAUSED THE PATIENT BLOOD GLUCOSE ELEVATED TO 234 MG/DL, WHICH RESULTS THAT THE PATIENT HAD VOMITING AND DIARRHEA. THE PATIENT WAS IN EMERGENCY ROOM FOR 24 HOURS AND FURTHER SUBSEQUENTLY GOT HOSPITALIZED DUE TO DIABETIC KETOACIDOSIS. THE PATIENT ALSO HAD KETONES 3.9 MMOL/L. THE INFUSION SET WAS IN USE FOR MORE THAN 24 HOURS. 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
901194 INFUSION DEVICES - UNKNOWN INFUSION DEVICES - UNKNOWN FPA UNOMEDICAL A/S UNKNOWN UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Hospitalization| R