FDA Adverse Event Malfunction Summary report: N

TRUSTEEL

MDR report key: 21165189 · Received January 16, 2025

Report

Report Number
3003442380-2024-37046
Event Type
Malfunction
Date Received
January 16, 2025
Date of Event
December 15, 2024
Report Date
June 20, 2025
Manufacturer
UNOMEDICAL A/S
Product Code
FPA
UDI-DI
05705244018457
PMA / PMN Number
K041545
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION - THIS MDR IS BEING SUBMITTED TO INCLUDE THE BELOW: H6: INVESTIGATION RESULTS UNDER TYPE OF INVESTIGATION, INVESTIGATION FINDINGS, INVESTIGATION CONCLUSIONS. THE REFERENCE SAMPLES FOR THE LOT 6001643 HAVE ALREADY BEEN PREVIOUSLY TESTED FOR VISUAL INSPECTION AND FOR FLOW (B)(4) ON (B)(6) 2024. ALL TEST RESULTS WERE WITHIN SPECIFICATIONS AS PER THE TEST REPORT (B)(4) TEST REPORT. DEVICE HISTORY RECORD (DHR) REVIEW: THE LOT 6001643 WAS MANUFACTURED ACCORDING TO THE WI VERSION 91 MANUFACTURED IN THE MACHINE MULTIVAC 10, ON 01/JUN/2023, WITH A TOTAL OF (B)(4) UNITS. WELDING LOT: THE LOT 3E05682 WAS MANUFACTURED ACCORDING TO THE WI VERSION 31 MANUFACTURED IN THE MACHINE LS25, ON 29/MAY/2023, WITH A TOTAL OF (B)(4) UNITS. THE LOT 3E05680 WAS MANUFACTURED ACCORDING TO THE WI VERSION 31 MANUFACTURED IN THE MACHINE LS11, ON 31/MAY/2023, WITH A TOTAL OF (B)(4) UNITS. THE LOT 3E03389 WAS MANUFACTURED ACCORDING TO THE WI VERSION 64 MANUFACTURED IN THE MACHINE LS11, ON 29/MAY/2023, WITH A TOTAL OF (B)(4) UNITS. GLUE-CONNECTOR LOT: THE LOT 3E05019 WAS MANUFACTURED ACCORDING TO THE WI VERSION 35 MANUFACTURED IN THE MACHINE MP03, ON 30/MAY/2023, WITH A TOTAL OF (B)(4) UNITS. THE LOT 3E05020 WAS MANUFACTURED ACCORDING TO THE WI VERSION 35 MANUFACTURED IN THE MACHINE MP03, ON 31/MAY/2023, WITH A TOTAL OF (B)(4) UNITS. THE LOT 3E04996 WAS MANUFACTURED ACCORDING TO THE WI VERSION 35 MANUFACTURED IN THE MACHINE MP03, ON 28/MAY/2023, WITH A TOTAL OF (B)(4) UNITS. THE LOT 3E04998 WAS MANUFACTURED ACCORDING TO THE WI VERSION 35 MANUFACTURED IN THE MACHINE MP03, ON 29/MAY/2023, WITH A TOTAL OF (B)(4) UNITS. THE LOT 3E04999 WAS MANUFACTURED ACCORDING TO THE WI VERSION 35 MANUFACTURED IN THE MACHINE MP03, ON 29/MAY/2023, WITH A TOTAL OF (B)(4) UNITS. THE LOT 3D00117 WAS MANUFACTURED ACCORDING TO THE WI VERSION 35 MANUFACTURED IN THE MACHINE MP03, ON 02/APR/2023, WITH A TOTAL OF (B)(4) UNITS. REVIEW OF THE DHR SHOWED THAT ALL RELEVANT TESTS REQUIRED DURING THE RELATED PROCESSES HAD BEEN FULFILLED AND MET THE REQUIREMENTS. NO DEVIATION WERE IDENTIFIED, NOR MAINTENANCE EVENTS WERE RECORDED. TRENDING: A QUERY WAS RUN IN DATABASE ON 17-JUN-2025 AGAINST MALFUNCTION CODE LEAKAGE FROM CONNECTION BETWEEN THE TUBING CONNECTOR AND THE INFUSION SET (CANNULA PART/BASE PIECE) AND LOT 6006114 AND NO MORE COMPLAINT HAVE BEEN REGISTERED IN DATABASE FOR THE SAME LOT 6006114 AND MALFUNCTION CODE. CONCLUSION SUMMARY OF THE RELATED EVENT: AS A RESULT OF THE FOLLOWING: NO DEFECT ON TESTS FOR RETENTION SAMPLES, NO NON-CONFORMANCE (NC) RAISED DURING PRODUCTION, NO MORE COMPLAINTS RECEIVED ON THE LOT IN QUESTION AND MALFUNCTION CODE, NO FURTHER ACTIONS ARE REQUIRED. THEREFORE, THIS ISSUE WILL BE MONITORED THROUGH THE POST MARKET SURVEILLANCE ACTIVITIES.

Description of Event or Problem · 0

REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES. IT WAS REPORTED THAT THE PATIENT FACED INSULIN FLOW BLOCKED ALARM EVENT ON (B)(6) 2024. THE BLOCKAGE WAS AT THE SITE. THE PATIENT REPLACED THE INFUSION SET AND RESUMED INSULIN DELIVERIES SUCCESSFULLY. NO FURTHER INFORMATION WAS AVAILABLE.

Description of Event or Problem · 0

TO DATE NO ADDITIONAL PATIENT OR EVENT DETAILS HAVE BEEN RECEIVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1509128 TRUSTEEL UNO CONTACT DETACH G29 80/6TCAP 10PK INT FPA UNOMEDICAL A/S 1002834 6001643 05705244018457

Patients

Seq Age Sex Outcome Treatment
1 73 YR Female