FDA Adverse Event Malfunction Summary report: N

AUTOSOFT XC

MDR report key: 20145268 · Received September 5, 2024

Report

Report Number
3003442380-2024-24288
Event Type
Malfunction
Date Received
September 5, 2024
Date of Event
July 15, 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 1963831- MDR 3003442380-2024-24288- DEVICE 10 OF 12

Description of Event or Problem · 0

REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES ON (B)(6)2024, IT WAS REPORTED THAT THE PATIENT ENCOUNTERED TEWLVE INFUSION SETS CANNULA KINKED EVENTS WITHIN 3 HOURS AFTER INSERTION. THE SITE OF INSERTION WAS ABDOMEN 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
1913046 AUTOSOFT XC UNO INSET I 60/6 GREY TCAP 10PK INT FPA UNOMEDICAL A/S 1001680 6003981 05705244016620

Patients

Seq Age Sex Outcome Treatment
1 67 YR Male