FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 1983309 · Received February 2, 2011

Report

Report Number
2531779-2011-00683
Event Type
Malfunction
Date Received
February 2, 2011
Report Date
January 6, 2011
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP WAS RETURNED TO ANIMAS AND EVALUATED. THE KEYPAD WAS FOUND TO BE INTACT WITH NO PEELING OR TEARS. THE PUMP WAS INTERMITTENTLY RESPONSIVE TO UP AND DOWN ARROW BUTTON PRESSES. THE KEYPAD WAS REMOVED FOR FURTHER INVESTIGATION. CONTAMINATION WAS OBSERVED UNDER THE OK, DOWN, AND UP ARROW BUTTON CONTACTS.

Description of Event or Problem · 1

THE PT CONTACTED ANIMAS ALLEGING THAT KEYPAD BUTTON PRESSES DID NOT ACTIVATE DESIRED PUMP FUNCTIONS. THE PT CLAIMED THAT THE OK BUTTON REQUIRED SEVERAL PRESSES IN ORDER FOR THE PUMP TO RESPOND. THE PT DENIED THAT THE DEVICE WAS EXPOSED TO WATER OR THAT THE KEYPAD WAS PEELING. THE PT DID NOT ALLEGE ANY HARM OR INJURY BECAUSE OF THE REPORTED ISSUE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM INSULIN INFUSION PUMP LZG ANIMAS CORP. ONE TOUCH PING NA

Patients

Seq Age Sex Outcome Treatment
1