FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 2110461 · Received April 25, 2011

Report

Report Number
2531779-2011-02796
Event Type
Malfunction
Date Received
April 25, 2011
Report Date
March 25, 2011
Manufacturer
ANIMAS CORP.
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE PUMP WAS RETURNED TO ANIMAS FOR EVAL. ALL KEYPAD BUTTONS DID NOT ACTIVATE DESIRED PUMP FUNCTIONS DURING TESTING. IT WAS ALSO OBSERVED THAT MULTIPLE BUTTON PRESSES WERE REQUIRED TO ENGAGE A RESPONSE. ALL BUTTONS DID NOT HAVE NORMAL SPRING BACK. THERE WAS EVIDENCE OF KEYPAD ADHESIVE FOUND UNDER ALL KEY CONTACTS.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE KEYPAD REQUIRED MULTIPLE PRESSES TO RESPOND. THE PT REPORTED HE DOES NOT GET THE PUMP WET.

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