BEUDAMED
    FDA Adverse Event Injury Summary report: N

    OT PING INSULIN PUMP

    MDR report key: 2222628 · Received August 25, 2011

    Report

    Report Number
    2531779-2011-02242
    Event Type
    Injury
    Date Received
    August 25, 2011
    Report Date
    March 2, 2011
    Manufacturer
    ANIMAS CORP
    Product Code
    LZG
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 0

    "REPORTER: (B)(6) FROM (B)(6). COMPLAINT: HOSPITALIZATION R/T HIGH BG. ANALYSIS: ANIMAS CANADA REP SPOKE TO PT'S WIFE AND FOUND PT WAS ADMITTED TO HOSPIRTAL ON (B)(6) FOR FLULIKE SYMPTOMS AND FOUND HIGH BG AND DKA. PT HAD N/V, ABD CRAMPS, SOB AND NOT SURE IF HAD CHEST PAIN. PER ANIMAS REP W IFE REFUSING TO TALK TO PS DUE TO SO MUCH GOING ON AT THIS TIME. PT MAY BE GOING HOME ON FRIDAY. WIFE ASK THAT PS CALL HER ON (B)(6) 201 TO OBTAIN INFORMATION, WHEN PT IS OUT OF THE HOSPITAL. CONCLUSION: UNABLE TO CONLCUDE TILL TROUBLE SHOOT PUMP".

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    369170 OT PING INSULIN PUMP PUMP, INFUSION, INSULIN LZG ANIMAS CORP ONETOUCH PING INSULIN PUMP

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Unknown Required Intervention