FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 2030737 · Received March 22, 2011

Report

Report Number
2531779-2011-01810
Event Type
Malfunction
Date Received
March 22, 2011
Report Date
February 23, 2011
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP WAS RETURNED TO ANIMAS FOR EVALUATION. THE KEYPAD WAS FOUND TO BE INTACT; NO PEELING OR LIFTING WAS OBSERVED. DURING INVESTIGATION, IT WAS FOUND THAT ALL KEYPAD BUTTON PRESSES DID NOT ACTIVATE DESIRED PUMP FUNCTIONS. THE BOLUS BUTTON WAS INTERMITTENTLY UNRESPONSIVE. THERE WAS EVIDENCE OF KEYPAD ADHESIVE FOUND UNDER ALL KEY CONTACTS. THE KEYPAD ADHESIVE WAS ALSO FOUND UNDER THE BOLUS BUTTON.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PUMP SELF SUSPENDED AND THE PUMP IS INCREASINGLY UNRESPONSIVE TO ALL BUTTON PRESSES. IT WAS REPORTED THAT THERE IS NO EXPOSURE TO WATER OR DAMAGE TO THE PUMP.

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 NA

Patients

Seq Age Sex Outcome Treatment
1