FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 2060747 · Received April 8, 2011

Report

Report Number
2531779-2011-02202
Event Type
Malfunction
Date Received
April 8, 2011
Date of Event
February 19, 2011
Report Date
March 5, 2011
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, 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 CONCLUSION CAN BE MADE AT THIS TIME.

Description of Event or Problem · 1

THE PATIENT REPORTED THAT THE OK KEYPAD BUTTON HAS BEEN STICKING FOR (B)(6). SHE NOTED THAT THE BUTTON NO LONGER SPRINGS BACK WHEN PRESSED. THE PATIENT DENIED PHYSICAL DAMAGE TO THE RUBBER KEYPAD.

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 38 YR