FDA Adverse Event
Malfunction
Summary report: N
AUTOSOFT XC
MDR report key: 20372245
·
Received October 4, 2024
Report
- Report Number
- 3003442380-2024-26181
- Event Type
- Malfunction
- Date Received
- October 4, 2024
- Date of Event
- August 30, 2024
- Report Date
- November 6, 2025
- 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 (B)(4). DEVICE 1 OF 4.
Description of Event or Problem · 0
REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES. IT WAS REPORTED THAT PATIENT FACED INFUSION SET TUBING DETACHMENT FROM HUB EVENT ON 30-AUG-2024, 31-AUG-2024 AND 1-SEP-2024. THE INFUSION SET WAS IN USE FOR ONE AND A HALF DAY. NO FURTHER INFORMATION AVAILABLE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 726349 | AUTOSOFT XC | UNO INSET I 60/6 GREY TCAP 10PK INT | FPA | UNOMEDICAL A/S | 1001680 | 6005474 | 05705244016620 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 32 YR | Female |