FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 2091227 · Received April 20, 2011

Report

Report Number
2531779-2011-02710
Event Type
Malfunction
Date Received
April 20, 2011
Date of Event
March 9, 2011
Report Date
March 23, 2011
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PUMP WAS RETURNED TO ANIMAS FOR EVALUATION. THE KEYPAD WAS FOUND TO BE INTACT; NO PEELING OR LIFTING WAS OBSERVED. VISUAL INSPECTION REVEALED THAT THE KEYPAD SYMBOLS ARE WORN. EVALUATION CONFIRMED THAT ALL KEYPAD BUTTONS ARE INTERMITTENTLY RESPONSIVE. THERE WAS EVIDENCE OF KEYPAD ADHESIVE FOUND UNDER ALL BUTTON KEY CONTACTS.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE KEYPAD BUTTONS WERE INTERMITTENTLY UNRESPONSIVE. THE PT REPORTED THAT THE UP ARROW, DOWN ARROW, AND OK KEYPAD BUTTONS HAVE BEEN INTERMITTENTLY UNRESPONSIVE FOR THE PAST 2 WEEKS. SHE NOTED THAT THE KEYPAD IS INTACT, BUT THE OK BUTTON SYMBOL IS WORN. THE PT STATED THAT THE BUTTONS NO LONGER CLICK AND SPRING BACK WHEN PRESSED, AND THAT THE BUTTONS FEEL FLAT. SHE REPORTED THAT SHE WEARS THE PUMP CLIPPED TO HER BRA.

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

Patients

Seq Age Sex Outcome Treatment
1 44 YR