FDA Adverse Event
Malfunction
Summary report: N
AUTOSOFT 90
MDR report key: 20093970
·
Received August 29, 2024
Report
- Report Number
- 3003442380-2024-22981
- Event Type
- Malfunction
- Date Received
- August 29, 2024
- Date of Event
- June 26, 2024
- Report Date
- July 30, 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 1953645- MDR 3003442380-2024-22981- DEVICE 8 OF 15
Description of Event or Problem · 0
REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES IT WAS REPORTED THAT THE PATIENT FACED LEAKAGE OF TUBING AT SITE. THE ISSUE OCCURRED WITH FIFTEEN TYPES OF INFUSION SETS USED FOR LESS THAN A DAY. NO FURTHER INFORMATION WAS AVAILABLE
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 271225 | AUTOSOFT 90 | UNO INSET II 60/9 BLUE TCAP 10PK INT | FPA | UNOMEDICAL A/S | 1002824 | 6001900 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 38 YR | Male |