FDA Adverse Event Malfunction Summary report: N

AUTOSOFT 90

MDR report key: 19728447 · Received July 12, 2024

Report

Report Number
3003442380-2024-13728
Event Type
Malfunction
Date Received
July 12, 2024
Date of Event
January 1, 2023
Report Date
July 12, 2024
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 1910171 - MDR 3003442380-2024-13728 - DEVICE 7 OF 10.

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 THE PATIENT ENCOUNTERED INFUSION SET CANNULA WAS KINKED WITHIN 3 HOURS OF INSERTION FOR 10 INFUSION SETS. PATIENT BLOOD GLUCOSE AT THE TIME OF ISSUE WAS REPORTED AS HIGH AND PATIENT TOOK CORRECTION INJECTION VIA MDI TO ADDRESS HIGH BG. THE SITE OF INSERTION WAS ABDOMEN. THE ISSUE GOT RESOLVED BY REPLACING THE 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.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2347973 AUTOSOFT 90 UNO INSET II 60/9 GREY TCAP 10PK INT FPA UNOMEDICAL A/S 1002819 UNKNOWN 05705244018181

Patients

Seq Age Sex Outcome Treatment
1 59 YR Female