FDA Adverse Event Malfunction Summary report: N

ANIMAS INSULIN INFUSION PUMP

MDR report key: 2070836 · Received April 15, 2011

Report

Report Number
2531779-2011-02643
Event Type
Malfunction
Date Received
April 15, 2011
Report Date
March 18, 2011
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K042873
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PUMP WAS RETURNED TO ANIMAS FOR EVALUATION. THE RESULTS OF THE INVESTIGATION WERE AS NOTED: THE KEYPAD APPEARED INTACT WITH NO LIFTING OR PEELING OBSERVED, ALL KEYPAD BUTTONS RESPONDED INTERMITTENTLY WHEN PRESSED, AND THERE WAS EVIDENCE OF ADHESIVE/CONTAMINATION FOUND UNDER ALL KEY CONTACTS.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE KEYPAD BUTTON PRESSES DID NOT ACTIVATE DESIRED PUMP FUNCTIONS. THE UP AND DOWN ARROW KEYPAD BUTTONS HAVE TO BE PRESSED MULTIPLE TIMES FOR A RESPONSE. THE REPORTER DENIED ANY DAMAGE/PEELING TO KEYPAD. THERE WAS NO ADVERSE EVENT ASSOCIATED WITH THIS COMPLAINT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ANIMAS INSULIN INFUSION PUMP INSULIN INFUSION PUMP LZG ANIMAS CORP. ANIMAS 2020 NA

Patients

Seq Age Sex Outcome Treatment
1