FDA Adverse Event
Malfunction
Summary report: N
ONETOUCHPING GLUCOSEMGMTSYSTEM
MDR report key: 2112278
·
Received June 3, 2011
Report
- Report Number
- 2531779-2011-03886
- Event Type
- Malfunction
- Date Received
- June 3, 2011
- Report Date
- May 10, 2011
- Manufacturer
- ANIMAS CORPORATION
- Product Code
- LZG
- PMA / PMN Number
- K080639
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- AZ, US
- Reporter Occupation
- PATIENT
Narratives
Additional Manufacturer Narrative · 1
THE PUMP HAS BEEN RETURNED AND EVALUATED BY PRODUCT ANALYSIS ON 05/26/2011 WITH THE FOLLOWING FINDINGS: THE KEYPAD BUTTONS WERE FOUND TO BE INTERMITTENTLY RESPONDING TO PRESSES. THE KEYPAD WAS REMOVED AND ADHESIVE WAS OBSERVED UNDER THE BUTTON CONTACTS. A REVIEW OF THE DEVICE HISTORY RECORD FOR THIS PUMP SHOWED THAT THE PUMP WAS OPERATING WITHIN SPECIFICATIONS AT THE TIME OF RELEASE.
Description of Event or Problem · 1
THE PATIENT'S FATHER REPORTED THAT THE BUTTONS HAVE BECOME UNRESPONSIVE TO BUTTON PRESSES. THE PATIENT REPORTEDLY DID NOT CLEAN THE PUMP.
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 | 9 YR |