FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 2031799 · Received March 21, 2011

Report

Report Number
2531779-2011-01764
Event Type
Malfunction
Date Received
March 21, 2011
Report Date
February 21, 2011
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K080639
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 EVALUATION. THE KEYPAD WAS FOUND TO BE INTACT; NO PEELING OR LIFTING WAS OBSERVED. DURING INVESTIGATION, IT WAS FOUND THAT THE UP ARROW, DOWN ARROW AND OK KEYPAD BUTTONS WERE INTERMITTENTLY RESPONSIVE. THERE WAS EVIDENCE OF KEYPAD ADHESIVE FOUND UNDER THE UP ARROW, DOWN ARROW AND OK KEY CONTACTS.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE UP ARROW, DOWN ARROW AND OK BUTTONS ARE UNRESPONSIVE. IT WAS REPORTED THAT THE PUMP WAS NOT EXPOSED TO WATER AND THERE IS NO KEYPAD PEELING.

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