FDA Adverse Event Malfunction Summary report: N

ANIMAS INSULIN INFUSION PUMP

MDR report key: 2020599 · Received February 16, 2011

Report

Report Number
2531779-2011-00520
Event Type
Malfunction
Date Received
February 16, 2011
Report Date
December 30, 2010
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K042873
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 FOR EVAL. THE RESULTS OF THE INVESTIGATION WERE AS NOTED: THE KEYPAD APPEARED INTACT WITH NO LIFTING OR PEELING OBSERVED, THE UP KEYPAD BUTTON INTERMITTENTLY RESPONDED TO USER INPUTS DURING TESTING, AND THERE WAS EVIDENCE OF ADHESIVE/CONTAMINATION FOUND UNDER THE UP KEY CONTACT.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE KEYPAD BUTTON PRESSES DID NOT ACTIVATE DESIRED PUMP FUNCTIONS. THE DOWN KEYPAD BUTTON IS INTERMITTENTLY UNRESPONSIVE WHEN PRESSED. THE KEYPAD IS INTACT. THERE WAS NO ADVERSE EVENT ASSOCIATED WITH THIS COMPLAINT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ANIMAS INSULIN INFUSION PUMP INSULIN INFUSION PUMP LZG ANIMAS CORP. ANIMAS 2020

Patients

Seq Age Sex Outcome Treatment
1