FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 2080070 · Received April 6, 2011

Report

Report Number
2531779-2011-02295
Event Type
Malfunction
Date Received
April 6, 2011
Report Date
March 9, 2011
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP WAS RETURNED TO ANIMAS FOR EVAL. THE UP ARROW, DOWN ARROW AND CONTRAST KEYPAD BUTTONS WERE INTERMITTENTLY RESPONSIVE DURING TESTING. THERE WAS EVIDENCE OF KEYPAD ADHESIVE FOUND UNDER THE UP ARROW, DOWN ARROW AND CONTRAST KEYPAD CONTACTS.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE UP AND DOWN ARROWS ARE INTERMITTENTLY UNRESPONSIVE. IT WAS REPORTED THE PUMP IS NOT EXPOSED TO WATER AND THE KEYPAD IS NOT PEELING.

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