FDA Adverse Event Malfunction Summary report: N

ANIMAS INSULIN INFUSION PUMP

MDR report key: 2072208 · Received April 28, 2011

Report

Report Number
2531779-2011-02974
Event Type
Malfunction
Date Received
April 28, 2011
Date of Event
March 30, 2011
Report Date
March 31, 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. ALL KEYPAD BUTTONS WERE INTERMITTENTLY ACTIVATING PUMP FUNCTIONS WHEN PRESSED.

Description of Event or Problem · 1

THE DISTRIBUTOR STATED THAT THE PATIENT NEEDED TO PRESS THE BUTTON SEVERAL TIMES TO ACTIVATE DESIRED PUMP FUNCTIONS.

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