FDA Adverse Event Malfunction Summary report: N

AUTOSOFT 90

MDR report key: 20862036 · Received December 6, 2024

Report

Report Number
3003442380-2024-33752
Event Type
Malfunction
Date Received
December 6, 2024
Date of Event
November 6, 2024
Report Date
January 25, 2025
Manufacturer
UNOMEDICAL A/S
Product Code
FPA
UDI-DI
05705244018129
PMA / PMN Number
K032854
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

SUPPLEMENTAL REPORT 02 - MDR 2062013. CORRECTION: THIS MDR IS BEING SUBMITTED TO CORRECT THE SUBMITTED REPORT NUMBER FOR SUPPLEMENT 1. SUPPLEMENTAL REPORT 01 - MDR 2062013 -MDR WAS SENT WITH REPORT NUMBER 3003442380-2024-33751.

Additional Manufacturer Narrative · 0

SUPPLEMENTAL REPORT 01 - (B)(4) - MDR 3003442380-2024-33752. ADDITIONAL INFORMATION - THIS MDR IS BEING SUBMITTED TO INCLUDE THE BELOW: H6: INVESTIGATION RESULTS UNDER TYPE OF INVESTIGATION, INVESTIGATION FINDINGS, INVESTIGATION CONCLUSIONS. H11: INVESTIGATION SUMMARY THE INFORMATION IN THIS COMPLAINT (B)(4) HAS BEEN EVALUATED. THE BATCH 6007373 IN QUESTION WAS MANUFACTURED AT THE REYNOSA SITE. INVESTIGATION PROCESS OF THE COMPLAINT WAS CARRIED OUT IN ACCORDANCE WITH WORK INSTRUCTION GUIDANCE FOR VISUAL TESTING FOR COMPLAINTS AREA VERSION 1 AND WORK INSTRUCTION GUIDANCE FOR FUNCTIONAL TESTING FOR COMPLAINTS AREA VERSION 1 FOR THE CODE "SOFT CANNULA FOUND KINKED UPON REMOVAL FROM INFUSION SITE." TEST RESULTS: VISUAL TEST ACCORDING TO WORK INSTRUCTION VERSION 1 ON REFERENCE SAMPLES, 10 SAMPLES OUT 10 SAMPLES PASSED THE TEST. FUNCTIONAL TEST AIR FLOW ACCORDING TO WORK INSTRUCTION VERSION 1 ON REFERENCE SAMPLES, 10 SAMPLES OUT 10 SAMPLES PASSED THE TEST. DEVICE HISTORY RECORD (DHR) REVIEW: REVIEW: THE LOT 6007373 WAS MANUFACTURED ACCORDING TO THE WORK INSTRUCTION VERSION 114 MANUFACTURED IN THE LINE 8, ON 03/JUN/2024, WITH A TOTAL OF (B)(4) UNITS. REVIEW OF THE DEVICE HISTORY RECORD (DHR) SHOWED THAT ALL RELEVANT TESTS REQUIRED DURING THE RELATED PROCESSES HAD BEEN FULFILLED AND MET THE REQUIREMENTS. NO DEVIATION WERE IDENTIFIED, NO MAINTENANCE EVENTS WERE RECORDED. TRENDING: A QUERY WAS RUN IN DATABASE ON 21/JAN/2025 AGAINST MALFUNCTION CODE "SOFT CANNULA FOUND KINKED UPON REMOVAL FROM INFUSION SITE." AND LOT 6007373 AND ANOTHER 22 COMPLAINTS HAVE BEEN REGISTERED IN DATABASE FOR THE SAME LOT 6007373 AND MALFUNCTION CODE.

Additional Manufacturer Narrative · 0

INITIAL AND FINAL MDR (B)(4). DEVICE 2 OF 3.

Description of Event or Problem · 0

TO DATE NO ADDITIONAL PATIENT OR EVENT DETAILS HAVE BEEN RECEIVED.

Description of Event or Problem · 0

TO DATE NO ADDITIONAL PATIENT OR EVENT DETAILS HAVE BEEN RECEIVED.

Description of Event or Problem · 0

REFERENCE NUMBER (B)(4). EVENT OCCURRED IN SPAIN. IT WAS REPORTED THAT PATIENT FACED THREE INFUSION SET CANNULA KINKED EVENT ON (B)(6) 2024 . THE EVENT OCCURRED WITHIN THREE HOURS OF INSERTION. THE INSERTION SITE WAS ABDOMEN. THE PATIENT REPLACED INFUSION SETS AND RESUMED INSULIN SUCCESSFULLY. COMPANY DO NOT SEE BENT/KINKING AS BEING RELATED TO HUMAN FACTORS, BUT RATHER AS A TRAINING ISSUE INCLUDING CORRECT CHOICES OF INSERTION SITES AND INFUSION SETS AND CANNULA LENGTH. FURTHERMORE, THE SOFT CANNULA IS A FLEXIBLE MATERIAL THAT DURING USE AND UPON REMOVAL CAN BEND SLIGHTLY. NO FURTHER INFORMATION WAS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2291053 AUTOSOFT 90 UNO INSET II 60/6 GREY TCAP 10PK INT FPA UNOMEDICAL A/S 1002817 6007373 05705244018129

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown