FDA Adverse Event
Malfunction
Summary report: N
AUTOSOFT 90
MDR report key: 19737517
·
Received July 14, 2024
Report
- Report Number
- 3003442380-2024-14509
- Event Type
- Malfunction
- Date Received
- July 14, 2024
- Date of Event
- June 4, 2024
- Report Date
- July 14, 2024
- Manufacturer
- UNOMEDICAL A/S
- Product Code
- FPA
- UDI-DI
- 05705244018150
- 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 1913027- MDR 3003442380-2024-14509- DEVICE 1 OF 10.
Description of Event or Problem · 0
UNOMEDICAL REFERENCE NUMBER 1913027 EVENT OCCURRED IN THE UNITED STATES. ON 04-JUNE-2024, IT WAS REPORTED BY THE PATIENT THAT TEN INFUSION SET CANNULA WAS KINKED AFTER 3 HOURS OF USE. INFUSION SET WAS PLACED IN LOWER BACK. PATIENT REPLACED INFUSION SET AND RESUMED INSULIN 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 WAS AVAILABLE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 209925 | AUTOSOFT 90 | UNO INSET II 110/6 GREY TCAP 10PK INT | FPA | UNOMEDICAL A/S | 1002818 | UNKNOWN | 05705244018150 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 22 YR | Male |