FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 2080074 · Received April 6, 2011

Report

Report Number
2531779-2011-02301
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. ALL KEYPAD BUTTON PRESSES DID NOT ACTIVATE DESIRED PUMP FUNCTIONS DURING TESTING. DURING INVESTIGATION, THE DOWN ARROW KEY CONTACT WAS OBSERVED TO BE MISALIGNED. THERE WAS EVIDENCE OF KEYPAD ADHESIVE FOUND UNDER ALL KEY CONTACTS.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE UP AND DOWN ARROWS ARE RESPONDING INTERMITTENTLY. IT WAS REPORTED THAT THERE IS NO WATER EXPOSURE TO THE PUMP AND THERE IS NO DAMAGE TO THE KEYPAD.

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