FDA Adverse Event Malfunction Summary report: N

ONETOUCHPING GLUCOSEMGMTSYSTEM

MDR report key: 2103099 · Received May 25, 2011

Report

Report Number
2531779-2011-03702
Event Type
Malfunction
Date Received
May 25, 2011
Report Date
April 29, 2011
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UT, US
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

THE PUMP WAS RETURNED TO ANIMAS FOR EVALUATION. THE KEYPAD BUTTONS WERE FOUND TO BE INTERMITTENTLY RESPONDING TO PRESSES. THE KEYPAD WAS REMOVED AND ADHESIVE WAS OBSERVED UNDER THE BUTTON CONTACTS.

Description of Event or Problem · 1

THE PATIENT REPORTED THAT KEYPAD BUTTONS REQUIRE MULTIPLE PRESSES TO ELICIT A RESPONSE. THE PATIENT REPORTEDLY DOES NOT CLEAN PUMP AND WEARS PUMP ON EXTERIOR OF GARMENT.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 33 YR