FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 2070547 · Received March 29, 2011

Report

Report Number
2531779-2011-02047
Event Type
Malfunction
Date Received
March 29, 2011
Report Date
March 1, 2011
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, 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. DURING INVESTIGATION, THE UP ARROW, DOWN ARROW AND CONTRAST KEYPAD BUTTONS WERE OBSERVED TO BE MISALIGNED. ALL KEYPAD BUTTONS INTERMITTENTLY SPRING BACK WHEN PRESSED. THERE WAS EVIDENCE OF KEYPAD ADHESIVE FOUND UNDER ALL KEY CONTACTS.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE BUTTONS WILL CONTINUE TO SCROLL AND THE PUMP INTERMITTENTLY LOCKS. THE PATIENT ALSO REPORTED THAT HE TOO MIGHT HAVE ACCIDENTALLY LOCKED IT WHEN DOING SOME BUTTON PRESSING.

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