FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 2030683 · Received March 22, 2011

Report

Report Number
2531779-2011-01782
Event Type
Malfunction
Date Received
March 22, 2011
Date of Event
January 1, 2010
Report Date
February 22, 2011
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PUMP HAS NOT BEEN RETURNED TO ANIMAS. IF THE DEVICE IS RETURNED, AN EVALUATION SHALL BE COMPLETED AND A SUPPLEMENTAL REPORT WILL BE FILED. NO CONCLUSIONS CAN BE MADE AT THIS TIME.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE KEYPAD BUTTONS WERE INTERMITTENTLY UNRESPONSIVE. THE PT REPORTED THAT THE KEYPAD BUTTONS HAVE BEEN INTERMITTENTLY UNRESPONSIVE FOR THE PAST FEW MONTHS. HE NOTED THAT THE KEYPAD BUTTONS FEEL SOFT WHEN PRESSED. THE PT DENIED EXPOSING THE PUMP TO WATER; STATED THAT THE RUBBER KEYPAD IS INTACT; AND STATED THAT HE CARRIES THE PUMP IN HIS PANTS POCKET OR ON HIS WAIST WITH A CLIP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM INSULIN INFUSION PUMP LZG ANIMAS CORP. ONE TOUCH PING

Patients

Seq Age Sex Outcome Treatment
1 20 YR