FDA Adverse Event Malfunction Summary report: N

AUTOSOFT XC

MDR report key: 19882176 · Received August 1, 2024

Report

Report Number
3003442380-2024-18565
Event Type
Malfunction
Date Received
August 1, 2024
Date of Event
June 6, 2024
Report Date
August 1, 2024
Manufacturer
UNOMEDICAL A/S
Product Code
FPA
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 1955099 - MDR 3003442380-2024-18565 - DEVICE 2 OF 3.

Description of Event or Problem · 0

UNOMEDICAL REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES. IT WAS REPORTED THAT THE PATIENT FACED SIMILAR EVENTS OF KINKED CANNULA WITH THREE INFUSION SETS AFTER BEING USED FOR LESS THAN A DAY. THE SYMPTOMS WERE NOTICED 3 OR MORE HOURS AFTER INSERTION. THE SITE OF INSERTION WAS REPORTED TO BE THIGH AND ARM AND THE SITE WAS ROTATED REGULARLY. PATIENT'S BLOOD GLUCOSE LEVEL AT THE TIME OF EVENT WAS 400 MG/DL SO PATIENT TOOK A CORRECTION BOLUS VIA PUMP. PATIENT REPLACED INFUSION SET AND RESUMED INSULIN SUCCESSFULLY. UNOMEDICAL DO NOT SEE 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
2075907 AUTOSOFT XC UNO INSET I 60/6 BLUE TCAP 10PK INT FPA UNOMEDICAL A/S 1001683 UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 7 YR Male