FDA Adverse Event Malfunction Summary report: N

ONE TOUCH PING GLUCOSE MANAGEMENT SYSTEM

MDR report key: 2110481 · Received April 25, 2011

Report

Report Number
2531779-2011-02798
Event Type
Malfunction
Date Received
April 25, 2011
Report Date
March 28, 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 THE KEYPAD BUTTONS REQUIRED MULTIPLE PRESSES TO ACTIVATE A RESPONSE. IT WAS FOUND THAT THE OK BUTTON CONTACT WAS INVERTED AND STUCK. IT WAS ALSO FOUND THAT ALL THE BUTTON CONTACTS WERE MISALIGNED. THE BUTTONS DID NOT HAVE NORMAL SPRING BACK. THERE WAS EVIDENCE OF KEYPAD ADHESIVE FOUND UNDER ALL KEY CONTACTS. IT WAS CONFIRMED THAT THE KEYPAD BUTTON SYMBOLS WERE WORN OFF.

Description of Event or Problem · 1

IT WAS REPORTED BY THE PT'S MOM THAT ALL THE BUTTONS ARE SUDDENLY UNRESPONSIVE. IT WAS REPORTED THAT THERE IS NO KNOWN TRAUMA TO KEYPAD.

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