FDA Adverse Event Malfunction Summary report: N

ONETOUCHPING GLUCOSEMGMTSYSTEM

MDR report key: 2102792 · Received May 25, 2011

Report

Report Number
2531779-2011-03690
Event Type
Malfunction
Date Received
May 25, 2011
Report Date
May 5, 2011
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

THE PUMP WAS RETURNED TO ANIMAS FOR EVALUATION AND EVALUATED. THE KEYPAD APPEARED TO BE INTACT; HOWEVER, THE "OK" BUTTON IS RESPONDING INTERMITTENTLY. REMOVED THE KEYPAD AND FOUND ADHESIVE UNDER THE CONTACTS AND INVERTED "OK" CONTACT.

Description of Event or Problem · 1

THE PATIENT CLAIMED THAT THE OK AND ENTER BUTTONS REQUIRED SEVERAL PRESSES TO ACTIVATE THE DESIRED PUMP FUNCTIONS. THE KEYPAD IS REPORTEDLY INTACT AND HAS NOT BEEN EXPOSED TO MOISTURE. THERE WAS NO ADVERSE EVENT ASSOCIATE WITH THIS COMPLAINT. THE PUMP WAS REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ONETOUCHPING GLUCOSEMGMTSYSTEM INSULIN INFUSION PUMP LZG ANIMAS CORPORATION ONETOUCH PING METER REMOTE

Patients

Seq Age Sex Outcome Treatment
1 54 YR