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