FDA Adverse Event Malfunction Summary report: N

AUTOSOFT XC

MDR report key: 20145231 · Received September 5, 2024

Report

Report Number
3003442380-2024-24197
Event Type
Malfunction
Date Received
September 5, 2024
Date of Event
July 28, 2024
Report Date
August 9, 2024
Manufacturer
UNOMEDICAL A/S
Product Code
FPA
UDI-DI
05705244016620
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 (B)(4) SINCE NO LOT NUMBER IS AVAILABLE, A DETAILED INVESTIGATION, TESTS OR REFERENCE SAMPLES OR BATCH REVIEW CANNOT BE CONCLUDED. THEREFORE, THIS COMPLAINT WILL BE CLOSED, THIS ISSUE WILL BE MONITORED THROUGH PMS PRODUCT TRENDS AND MALFUNCTION. IF ANY TRENDS PICKED UP, THIS WILL FLAG ON THE TRIPS AND ALERTS ACCORDING TO THE OMQR PROCEDURE.

Description of Event or Problem · 0

REFERENCE NUMBER 1963822 EVENT OCCURRED IN THE UNITED STATES . ON (B)(6) 2024, IT WAS REPORTED THAT THE PATIENT ENCOUNTERED TWO INFUSION SETS CANNULA KINKED EVENTS WITHIN 3 HOURS AFTER INSERTION. THE SITE OF INSERTION WAS ABDOMEN.. THE INFUSION SET WAS IN USE FOR 6HRS. 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.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1836224 AUTOSOFT XC UNO INSET I 60/6 GREY TCAP 10PK INT FPA UNOMEDICAL A/S 1001680 UNKNOWN 05705244016620

Patients

Seq Age Sex Outcome Treatment
1 38 YR Male