FDA Adverse Event Malfunction Summary report: N

ANIMAS INSULIN INFUSION PUMP

MDR report key: 2071941 · Received April 28, 2011

Report

Report Number
2531779-2011-02961
Event Type
Malfunction
Date Received
April 28, 2011
Date of Event
April 1, 2011
Report Date
April 4, 2011
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
PMA / PMN Number
K042873
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(6).THE PUMP WAS RETURNED TO ANIMAS. EVALUATION REVEALED CONTAMINATION UNDER KEYPAD BUTTON CONTACTS AND THAT THE KEYPAD BUTTONS WERE INTERMITTENTLY ACTIVATING PUMP FUNCTIONS WHEN PRESSED. UNRELATED TO THE ISSUE, THE PUMP BATTERY COMPARTMENT WAS CRACKED WHICH IS NOT LIKELY TO CAUSE OR CONTRIBUTE TO A SERIOUS INJURY AS IT IS OBVIOUS AND DETECTABLE AND THE OWNER'S BOOKLET INSTRUCTS THE USER TO CHECK FOR CHIPS, CRACKS AND LEAKS.

Description of Event or Problem · 1

THE DISTRIBUTOR REPORTED THAT THE OK BUTTON WAS STICKING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ANIMAS INSULIN INFUSION PUMP INSULIN INFUSION PUMP LZG ANIMAS CORPORATION ANM 2020 INSULIN INFUSION PUMP

Patients

Seq Age Sex Outcome Treatment
1